The WISTAH hand study: a prospective cohort study of distal upper extremity musculoskeletal disorders.

PubMed

Garg, Arun; Hegmann, Kurt T; Wertsch, Jacqueline J; Kapellusch, Jay; Thiese, Matthew S; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Kendall, Richard; Sheng, Xiaoming; Holubkov, Richard

2012-06-06

Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain's stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers' jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date.

Association between Upper Extremity Musculoskeletal Disorders and Psychosocial Factors at Work: A Review on the Job DCS Model's Perspective.

PubMed

Park, Jung-Keun; Jang, Seung-Hee

2010-09-01

Over years it has been increasingly concerned with how upper extremity musculoskeletal disorders (UEMSDs) are attributed to psychosocial job stressors. A review study was conducted to examine associations between UEMSDs and psychosocial work factors, and to recommend what to consider for the associations. For studies in which the job demand-control-support (DCS) model or its variables were specifically employed, published papers were selected and reviewed. A number of studies have reported relationships between UEMSDs symptoms and psychosocial exposure variables. For example, the findings are: higher numbness in the upper extremity was significantly attributed to by less decision latitude at work; work demands were significantly associated with neck and shoulder symptoms while control over time was associated with neck symptoms; and the combination of high psychosocial demands and low decision latitude was a significant predictor for shoulder and neck pain in a female working population. Sources of bias, such as interaction or study design, were discussed. UEMSDs were shown to be associated with psychosocial work factors in various studies where the job DCS model was addressed. Nonetheless, this review suggests that further studies should be conducted to much more clarify the association between UEMSDs and psychosocial factors.

Professional musicians with craniomandibular dysfunctions treated with oral splints.

PubMed

Steinmetz, Anke; Ridder, Paul H; Methfessel, Götz; Muche, Burkhard

2009-10-01

Craniomandibular dysfunction (CMD) symptoms occur frequently in violin/viola and wind players and can be associated with pain in the neck, shoulders and arm. In the current study, the effect of oral splint treatment of CMD on reducing pain and symptoms especially in these areas was investigated. Thirty (30) musicians undergoing CMD treatment with oral splints participated in this study. They completed a questionnaire that addressed CMD symptoms, localization of pain, and subjective changes in symptoms. Pain in the shoulder and/or upper extremity was the most frequent symptom reported by 83% of subjects, followed by neck pain (80%) and pain in the teeth/TMJ regions (63%). Treatment with oral splints contributed to a significant decrease in neck pain in 91%, teeth/TMJ pain in 83%, and shoulder and upper extremity pain in 76% of the musicians. Eighty percent (80%) of the patients reported improvement of their predominant symptoms. CMD can be a potential cause for pain in the neck, shoulders, and upper extremities of musicians. It is paramount that musicians with musculoskeletal problems be examined for CMD symptoms. Treatment with oral splints seems to be valuable. Further prospective, randomized controlled studies are necessary to confirm efficacy of oral splint treatment in CMD-associated pain and problems in the neck, shoulder, and the upper extremities in musicians.

Prevalence of work related musculoskeletal disorders in active union carpenters

PubMed Central

Lemasters, G. K.; Atterbury, M. R.; Booth-Jones, A. D.; Bhattacharya, A.; Ollila-Glenn, N.; Forrester, C.; Forst, L.

1998-01-01

OBJECTIVES: To determine the prevalence and risk factors for work related musculoskeletal disorders among union carpenters. METHODS: A detailed questionnaire on musculoskeletal symptoms and work history was administered to 522 carpenters. The symptom questions assessed if carpenters experienced pain, numbness, or tingling in a particular body region. A subset of this group then received a physical examination of the upper extremities and knees. RESULTS: The study group was primarily white (94.9%) and male (97.8%) with a mean age of 42.3 years. The highest prevalence of work related musculoskeletal disorders cases by carpentry specialty ranged from 20%-24% for those doing drywall or ceiling, finishing or framing, and the building of concrete forms. Generally, as duration of employment increased, the prevalence of symptoms increased. An adjusted logistic regression analysis showed that the group with the longest (> or = 20 years) duration of employment in carpentry was significantly associated with work related musculoskeletal disorders of the shoulders (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.1 to 8.9), hands or wrists (OR 3.1, 95% CI 1.1 to 8.4), and knees (OR 3.5, 95% CI 1.3 to 9.2). Also, analyses showed that carpenters who reported that they had little or no influence over their work schedule had significant increases of work related musculoskeletal disorders of the shoulders, hips, and knees with ORs of 1.9 (95% CI 1.1 to 3.2), 2.9 (95% CI 1.1 to 7.2), and 2.3 (95% CI 1.2 to 4.1), respectively. Feeling exhausted at the end of day was also a significant risk factor for work related musculoskeletal disorders of the knee (OR 1.8, 95% CI 1.1 to 3.1). Upper extremity disorders were the most prevalent work related musculoskeletal disorders reported among all carpenters. Drywall or ceiling activities involve a considerable amount of repetitive motion and awkward postures often with arms raised holding heavy dry walls in place, whereas form work is notable for extensive lumbar flexion and had the two highest rates of work related musculoskeletal disorders. The psychosocial element of job control was associated with both upper and lower extremity disorders. These union carpenters, who were relatively young, already were experiencing considerable work related physical problems. CONCLUSION: This study supports the need for vigilant ergonomic intervention at job sites and early ergonomic education as an integral part of apprenticeship school training to ensure that carpenters remain fit and healthy throughout their working lifetime.   PMID:9764103

Prevalence of work related musculoskeletal disorders in active union carpenters.

PubMed

Lemasters, G K; Atterbury, M R; Booth-Jones, A D; Bhattacharya, A; Ollila-Glenn, N; Forrester, C; Forst, L

1998-06-01

To determine the prevalence and risk factors for work related musculoskeletal disorders among union carpenters. A detailed questionnaire on musculoskeletal symptoms and work history was administered to 522 carpenters. The symptom questions assessed if carpenters experienced pain, numbness, or tingling in a particular body region. A subset of this group then received a physical examination of the upper extremities and knees. The study group was primarily white (94.9%) and male (97.8%) with a mean age of 42.3 years. The highest prevalence of work related musculoskeletal disorders cases by carpentry specialty ranged from 20%-24% for those doing drywall or ceiling, finishing or framing, and the building of concrete forms. Generally, as duration of employment increased, the prevalence of symptoms increased. An adjusted logistic regression analysis showed that the group with the longest (> or = 20 years) duration of employment in carpentry was significantly associated with work related musculoskeletal disorders of the shoulders (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.1 to 8.9), hands or wrists (OR 3.1, 95% CI 1.1 to 8.4), and knees (OR 3.5, 95% CI 1.3 to 9.2). Also, analyses showed that carpenters who reported that they had little or no influence over their work schedule had significant increases of work related musculoskeletal disorders of the shoulders, hips, and knees with ORs of 1.9 (95% CI 1.1 to 3.2), 2.9 (95% CI 1.1 to 7.2), and 2.3 (95% CI 1.2 to 4.1), respectively. Feeling exhausted at the end of day was also a significant risk factor for work related musculoskeletal disorders of the knee (OR 1.8, 95% CI 1.1 to 3.1). Upper extremity disorders were the most prevalent work related musculoskeletal disorders reported among all carpenters. Drywall or ceiling activities involve a considerable amount of repetitive motion and awkward postures often with arms raised holding heavy dry walls in place, whereas form work is notable for extensive lumbar flexion and had the two highest rates of work related musculoskeletal disorders. The psychosocial element of job control was associated with both upper and lower extremity disorders. These union carpenters, who were relatively young, already were experiencing considerable work related physical problems. This study supports the need for vigilant ergonomic intervention at job sites and early ergonomic education as an integral part of apprenticeship school training to ensure that carpenters remain fit and healthy throughout their working lifetime.

Effects of Self Stretching on Pain and Musculoskeletal Symptom of Bus Drivers

PubMed Central

Lee, Jung-Ho; Gak, Hwang Bo

2014-01-01

[Purpose] The aim of this study was to evaluate the musculoskeletal symptoms, pain and risk of postures as well as the effects of stretching exercise on the work-related symptoms and pain of bus drivers. [Subjects and Methods] Eighty-one drivers were randomly recruited from a bus corporation for this study. Information about pain levels, painful regions, and general characteristics of subjects was obtained using the symptom research form (KOSHA Code H-30-2003). The level of pain was assessed on a scale of numeric rating scale (NRS) which is divided by 10. Ergonomic posture assessment was conducted using the rapid upper limb assessment (RULA). Self-stretching exercise was performed for 4 weeks by the bus drivers who suffered from neck and shoulder pain. [Results] Musculoskeletal symptoms were present in the order of shoulder, neck, lower back and lower extremities. Compared with other jobs, the final score, and the action level of bus drivers were very high, showing 57.6% of action levels 3 and 4. A statistically significant decrease of pain was shown after the self-stretching intervention. There was also a significant decrease of musculoskeletal symptoms in the neck and shoulders after the self-stretching exercise. [Conclusion] Performing stretching for musculoskeletal symptoms had a positive influence on the symptoms and reduced pain. PMID:25540496

Psychosocial factors and shoulder symptom development among workers.

PubMed

Smith, Caroline K; Silverstein, Barbara A; Fan, Z Joyce; Bao, Stephen; Johnson, Peter W

2009-01-01

Shoulder injuries are a common cause of pain and discomfort. Many work-related factors have been associated with the onset of shoulder symptoms. The psychosocial concepts in the demand-control model have been studied in association with musculoskeletal symptoms but with heterogeneous findings. The purpose of this study was to assess the relationship between the psychosocial concepts of the demand-control model and the incidence of shoulder symptoms in a working population. After following 424 subjects for approximately 1 year, 85 incident cases were identified from self-reported data. Cox proportional hazards modeling was used to assess the associations between shoulder symptoms and demand-control model quadrants. Cases were more likely to be female and report other upper extremity symptoms at baseline (P < 0.05). From the hazard models, being in either a passive or high strain job quadrant was associated with the incidence of shoulder symptoms. Hazard ratios were 2.17, 95% CI 1.02-4.66 and 2.19, 95% CI 1.08-4.42, respectively. Using self-reporting to determine demand-control quadrants was successful in identifying subjects at risk of developing work-related shoulder symptoms. Research is needed to determine if this relationship holds with clinically diagnosed shoulder and other upper extremity musculoskeletal disorders. This may be part of a simple tool for assessing risk of developing these UEMSDs. (c) 2008 Wiley-Liss, Inc.

Incidence and prevalence of complaints of the neck and upper extremity in general practice

PubMed Central

Bot, S; van der Waal, J M; Terwee, C; van der Windt, D A W M; Schellevis, F; Bouter, L; Dekker, J

2005-01-01

Objective: To study the incidence and prevalence of neck and upper extremity musculoskeletal complaints in Dutch general practice. Methods: Data were obtained from the second Dutch national survey of general practice. In all, 195 general practitioners (GPs) from 104 practices across the Netherlands recorded all contacts with patients during 12 consecutive months. Incidence densities and consultation rates were calculated. Results: The total number of contacts during the registration period of one year was 1 524 470. The most commonly reported complaint was neck symptoms (incidence 23.1 per 1000 person-years), followed by shoulder symptoms (incidence 19.0 per 1000 person-years). Sixty six GP consultations per 1000 person-years were attributable to a new complaint or new episode of complaint of the neck or upper extremity (incidence density). In all, the GPs were consulted 147 times per 1000 registered persons for complaints of the neck or upper extremity. For most complaints the incidence densities and consultation rates were higher for women than for men. Conclusions: Neck and upper extremity symptoms are common in Dutch general practice. The GP is consulted approximately seven times each week for a complaint relating to the neck or upper extremity; of these, three are new complaints or new episodes. Attention should be paid to training GPs to deal with neck and upper limb complaints, and to research on the prognosis and treatment of these common complaints in primary care. PMID:15608309

Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial.

PubMed

Esmaeilzadeh, Sina; Ozcan, Emel; Capan, Nalan

2014-01-01

The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers. Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months. In the intervention group, body posture (p < 0.001) and workstation layout (p = 0.002) improved over 6 months; furthermore, intensity (p < 0.001), duration (p < 0.001), and frequency (p = 0.009) of WUEMSS decreased significantly in the intervention group compared with the control group. Additionally, the functional status (p = 0.001), and physical (p < 0.001), and mental (p = 0.035) health-related quality of life improved significantly compared with the controls. There was no improvement of work day loss due to WUEMSS (p > 0.05). Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.

Upper extremity musculoskeletal discomfort among occupational notebook personal computer users: work interference, associations with risk factors and the use of notebook computer stand and docking station.

PubMed

Erdinc, Oguzhan

2011-01-01

This study explored the prevalence and work interference (WI) of upper extremity musculoskeletal discomfort (UEMSD) and investigated the associations of individual and work-related risk factors and using a notebook stand or docking station with UEMSD among symptomatic occupational notebook personal computer (PC) users. The participant group included 45 Turkish occupational notebook PC users. The study used self-reports of participants. The Turkish version of the Cornell Musculoskeletal Discomfort Questionnaire (T-CMDQ) was used to collect symptom data. UEMSD prevailed mostly in the neck, the upper back, and the lower back with prevalence rates of 77.8%, 73.3%, and 60.0% respectively, and with WI rates of 28.9%, 24.4%, and 26.7% respectively. Aggregated results showed that 44% of participants reported WI due to UEMSD in at least one body region. Significant risk factors were: being female, being aged <31 years, having computer work experience <10 years, and physical discomfort during computer use. UEMSD prevalence and WI rates were considerable in the neck, the upper back, and the lower back. Significant associations between certain risk factors and UEMSD were identified, but no association was found between using notebook stand and docking station and UEMSD among participants.

Exploring Occupational Therapists’ Perceptions of the Usefulness of Musculoskeletal Sonography in Upper-Extremity Rehabilitation

PubMed Central

McLaughlin Gray, Julie; Frank, Gelya; Wolkoff, Monique

2015-01-01

OBJECTIVE. To identify the potential utility of musculoskeletal sonographic imaging in upper-extremity rehabilitation. METHOD. Two occupational therapists in an outpatient hand rehabilitation clinic were recruited by convenience, were trained in the use of sonography, and implemented sonographic imaging in their clinical practice. Qualitative data were obtained during and after the implementation period by means of questionnaires and interviews. Data collection, analysis, and interpretation were completed in an iterative process that culminated in a thematic analysis of the therapists’ perceptions. RESULTS. The data indicate four potential areas of utility for musculoskeletal sonography in upper-extremity rehabilitation: (1) mastering anatomy and pathology, (2) augmenting clinical reasoning, (3) supplementing intervention, and (4) building evidence. CONCLUSION. Numerous potential uses were identified that would benefit both therapist and client. Further exploration of complexities and efficacy for increasing patient outcomes is recommended to determine best practices for the use of musculoskeletal sonography in upper-extremity rehabilitation. PMID:26114469

Generalised joint hypermobility and shoulder joint hypermobility, - risk of upper body musculoskeletal symptoms and reduced quality of life in the general population.

PubMed

Juul-Kristensen, Birgit; Østengaard, Lasse; Hansen, Sebrina; Boyle, Eleanor; Junge, Tina; Hestbaek, Lise

2017-05-30

Generalised Joint Hypermobility (GJH) is a hereditary condition with an ability to exceed the joints beyond the normal range. The prevalence of GJH in the adult population and its impact on upper body musculoskeletal health and quality of life has mostly been studied in selected populations. The aims of this study were therefore, firstly to study the prevalence of GJH and GJH including shoulder hypermobility (GJHS), in the general Danish adult population; secondly to test the associations between GJH or GJHS and upper body musculoskeletal symptoms and health-related quality of life (HRQoL). The study was cross-sectional where 2072 participants, aged 25-65, randomly extracted from the Danish Civil Registration System), were invited to answer a questionnaire battery (Five-Part Questionnaire for classification of GJH, Standardised Nordic Questionnaire for musculoskeletal symptoms, EuroQoL-5D for HRQoL). Totally 1006 (49%) participants responded. The prevalence of GJH and GJHS were 30% (n = 300) and 5% (n = 51), respectively. Compared with Non GJH (NGJH), participants with GJH and GJHS had Odds Ratio (OR) of 1.5-3.5 for upper body musculoskeletal symptoms within the last 12 months (mostly shoulders and hands/wrists). GJH and GJHS also had OR 1.6-4.4 for being prevented from usual activities, mostly due to shoulder and neck symptoms. Furthermore, GJH and GJHS had OR 2.2-3.1 for upper body musculoskeletal symptoms lasting for more than 90 days (neck, shoulders, hand/wrists), and 1.5-3.5 for reduced HRQoL (all dimensions, but anxiety/depression) compared with NGJH. Generally, most OR for GJHS were about twice as high as for those having GJH alone. GJH and GJHS are frequently self-reported musculoskeletal conditions in the Danish adult population. Compared with NGJH, GJH and especially GJHS, present with higher OR for upper body musculoskeletal symptoms, more severe symptoms and decreased HRQoL.

Ergonomics intervention in an Iranian television manufacturing industry.

PubMed

Motamedzade, M; Mohseni, M; Golmohammadi, R; Mahjoob, H

2011-01-01

The primary goal of this study was to use the Strain Index (SI) to assess the risk of developing upper extremity musculoskeletal disorders in a television (TV) manufacturing industry and evaluate the effectiveness of an educational intervention. The project was designed and implemented in two stages. In first stage, the SI score was calculated and the Nordic Musculoskeletal Questionnaire (NMQ) was completed. Following this, hazardous jobs were identified and existing risk factors in these jobs were studied. Based on these data, an educational intervention was designed and implemented. In the second stage, three months after implementing the interventions, the SI score was re-calculated and the Nordic Musculoskeletal Questionnaire (NMQ) completed again. 80 assembly workers of an Iranian TV manufacturing industry were randomly selected using simple random sampling approach. The results showed that the SI score had a good correlation with the symptoms of musculoskeletal disorders. It was also observed that the difference between prevalence of signs and symptoms of musculoskeletal disorders, before and after intervention, was significantly reduced. A well conducted implementation of an interventional program with total participation of all stakeholders can lead to a decrease in musculoskeletal disorders.

Upcoming Paralympic summer games in Rio: what did the German medical team learn from the London Games?

PubMed

Kubosch, Eva J; Kosel, Jürgen; Steffen, Kathrin; Konstantinidis, Lukas; Kubosch, David; Südkamp, Norbert P; Hirschmüller, Anja

2017-11-01

Musculoskeletal complaints are frequently diagnosed in Paralympic athletes. Despite the increased professionalism in Paralympic Sports, the documentation of injuries and other health complaints during high-level competition is sparse. With respect to the upcoming Paralympic Summer Games in Rio de Janeiro, the aim of this study was the analysis of all musculoskeletal complaints within the German Paralympic Athletes during the London 2012 Paralympic Games. All musculoskeletal complaints (MSC) of the 150 German athletes seeking medical attention, hereby defined as "injury", were recorded during the in-competition period of the London Paralympics Games (22 days), regardless of their severity and consequences. Standardized documentation included the onset of symptoms, the medical diagnoses, the therapeutic measures taken as well as consecutive restrictions in training and competition. Incidence rates and localizations were analyzed by sports discipline. A total of 201 musculoskeletal complaints were recorded for 140 athletes (93.3%), corresponding to 1.4 musculoskeletal complaints per "injured" athlete. The incidence of musculoskeletal complaints in German athletes was 62.9±15.4/1000 athlete-days. High incidence rates (IR) were observed in wheelchair basketball (IR 72/1000 athlete-days, 1.6 injuries per athlete) and equestrian events (IR 72.7, 1.6). Musculoskeletal complaints were mainly located in the upper extremities (37.6%) and the spine (37.6%). The most frequent diagnoses were myalgia (N.=105, 52%). We noted a high rate of musculoskeletal complaints among German Paralympic athletes across sports and body parts, highlighting the need for prevention programs that focus on the upper extremities and spine.

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users.

PubMed

Gerr, F; Marcus, M; Monteilh, C; Hannan, L; Ortiz, D; Kleinbaum, D

2005-07-01

To examine the effect of two workstation and postural interventions on the incidence of musculoskeletal symptoms among computer users. Randomised controlled trial of two distinct workstation and postural interventions (an alternate intervention and a conventional intervention) among 376 persons using computer keyboards for more than 15 hours per week. The incidence of neck/shoulder symptoms and hand/arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention (comparison group). For individuals in the intervention groups, study staff adjusted workstations, where possible, and trained individuals to assume the intervention postures. Individuals reported musculoskeletal symptoms in a weekly diary. Participants who reported discomfort intensity of 6 or greater on a 0-10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic. There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups. Twenty two (18.5%) participants in the alternate intervention group, 25 (20.2%) in the conventional intervention group, and 25 (21.7%) in the comparison group developed incident arm or hand symptoms. Thirty eight (33.3%) participants in the alternate intervention group, 36 (31.0%) in the conventional intervention group, and 33 (30.3%) in the comparison group developed incident neck or shoulder symptoms. Compliance with all components of the intervention was attained for only 25-38% of individuals, due mainly to the inflexibility of workstation configurations. This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users.

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users

PubMed Central

Gerr, F; Marcus, M; Monteilh, C; Hannan, L; Ortiz, D; Kleinbaum, D

2005-01-01

Aims: To examine the effect of two workstation and postural interventions on the incidence of musculoskeletal symptoms among computer users. Methods: Randomised controlled trial of two distinct workstation and postural interventions (an alternate intervention and a conventional intervention) among 376 persons using computer keyboards for more than 15 hours per week. The incidence of neck/shoulder symptoms and hand/arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention (comparison group). For individuals in the intervention groups, study staff adjusted workstations, where possible, and trained individuals to assume the intervention postures. Individuals reported musculoskeletal symptoms in a weekly diary. Participants who reported discomfort intensity of 6 or greater on a 0–10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic. Results: There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups. Twenty two (18.5%) participants in the alternate intervention group, 25 (20.2%) in the conventional intervention group, and 25 (21.7%) in the comparison group developed incident arm or hand symptoms. Thirty eight (33.3%) participants in the alternate intervention group, 36 (31.0%) in the conventional intervention group, and 33 (30.3%) in the comparison group developed incident neck or shoulder symptoms. Compliance with all components of the intervention was attained for only 25–38% of individuals, due mainly to the inflexibility of workstation configurations. Conclusions: This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users. PMID:15961625

Risk Factors for Upper Extremity Musculoskeletal Disorders Among Office Workers in Qom Province, Iran.

PubMed

Alavi, Seyedeh Shohreh; Abbasi, Mahya; Mehrdad, Ramin

2016-10-01

The identification of the risk factors for musculoskeletal disorders (MSDs) is the first step in designing effective preventive interventions. To investigate the association between individual, organizational, physical, and psychological factors and upper extremity MSDs (i.e., shoulder, elbow and hand/wrist). In this cross-sectional study, the study population was comprised of office workers from Qom Province, Iran. Of the 1630 Iranian office workers who were selected via a random multistage cluster sampling method, 1488 completed a comprehensive data collection form designed to investigate the individual, organizational, physical, and psychological factors related to MSDs (response rate: 91.3%). The predictors of shoulder MSDs in the past 12 months were uncomfortable sitting posture (β = 0.42, P = 0.04), limited rest breaks (β=0.73, P = 0.012), and no access to adjustable desks (β = 0.43, P = 0.018). Working on a computer for more than five hours (β = 0.61, P = 0.004) and an uncomfortable sitting posture (β = 0.79, P = 0.001) predicted hand/wrist symptoms. Various risk factors in the workplace may contribute to MSDs in different upper extremities. Preventive interventions should hence include ergonomic and office equipment modifications.

Evaluation of two posture survey instruments for assessing computing postures among college students

PubMed Central

Menéndez, Cammie Chaumont; Amick, Benjamin C.; Chang, Che-Hsu (Joe); Harrist, Ronald B.; Jenkins, Mark; Robertson, Michelle; Janowitz, Ira; Rempel, David M.; Katz, Jeffrey N.; Dennerlein, Jack T.

2012-01-01

Objective To determine agreement between two posture assessment survey instruments and which, if any, were correlated with experiencing upper extremity musculoskeletal symptoms. Methods Thirty undergraduate participants had three postural assessment surveys completed, one each for three separate 7-day data collection periods during a semester. Two observation assessment tools were used, a modified Rapid Upper Limb Assessment (mRULA) for computer users for the right and left limbs and the University of California Computer Use Checklist. Concurrently, upper extremity musculoskeletal symptom experience paired to each postural assessment was measured. Lin’s concordance correlation coefficient evaluated survey agreement and multi-level statistical models described associations between survey responses and symptoms. Results There was no agreement between the two postural assessment tool scores (p > 0.85). In adjusted models, the UC Computer Use Checklist was positively associated with symptoms occurrence (OR = 1.4, 90% CI 1.2–1.6 for any symptoms; OR = 1.3, 90% CI 1.0–1.6 for moderate or greater symptoms). Associations with mRULA scores were inconsistent in that they were sometimes protective and sometimes indicators of risk, depending on the covariates included in the models. Conclusion The mRULA for computer users and the UC Computer Use Checklist were independent of each other; however, due to the inconsistent associations with symptoms we cannot conclude one instrument is superior to the other. Our data do suggest the UC Computer Use Checklist demonstrates a traditional relationship with symptoms, where increasing scores signifiy greater risk. We observed a nontraditional relatioship with symptoms for the mRULA for computer users that needs to be further examined. This is a pilot study and, thus, findings should be interpreted as exploratory. Associations observed in the current study will be used to test hypotheses in the cohort study recently conducted. PMID:20075519

Aromatase inhibitor associated musculoskeletal symptoms are associated with reduced physical activity among breast cancer survivors.

PubMed

Brown, Justin C; Mao, Jun J; Stricker, Carrie; Hwang, Wei-Ting; Tan, Kay-See; Schmitz, Kathryn H

2014-01-01

Physical activity (PA) has numerous health benefits for breast cancer survivors. Recent data suggest that some breast cancer survivors treated with aromatase inhibitors may experience aromatase inhibitor associated musculoskeletal symptoms. It is unknown whether aromatase inhibitor associated musculoskeletal symptoms are associated with reduced PA and what other risk factors are associated with such PA reductions. We conducted a cross-sectional study at a large university-based breast cancer clinic among breast cancer survivors prescribed an aromatase inhibitor. At routine follow-up, we surveyed participants about aromatase inhibitor associated musculoskeletal symptoms, as well as pre-aromatase inhibitor, and current, PA levels. Among 300 participants, 90 (30%) reported a reduction of PA since the initiation of aromatase inhibitor therapy. Those with aromatase inhibitor associated musculoskeletal symptoms were more likely to report decreased PA (62% versus 38%, p = 0.001) compared with those without aromatase inhibitor associated musculoskeletal symptoms. In multivariate analyses, aromatase inhibitor associated musculoskeletal symptoms (odds ratio [OR] = 2.29 [95% confidence interval [CI]: 1.36-3.86]), and body mass index (OR = 1.06 [95% CI: 1.02-1.12]) were associated with reductions in PA. In subgroup analysis among breast cancer survivors with aromatase inhibitor associated musculoskeletal symptoms, self-reported lower extremity joint pain (OR = 1.23 [95% CI: 1.00-1.50]) and impaired lower extremity physical function (OR = 1.07 [95% CI: 1.01-1.14]) were associated with reductions in PA. Breast cancer survivors with aromatase inhibitor associated musculoskeletal symptoms were more likely to report reductions in PA since initiating aromatase inhibitor therapy compared with those without aromatase inhibitor associated musculoskeletal symptoms. Our findings suggest that tailored interventions targeting lower extremity functional limitations are needed to enable breast cancer survivors with aromatase inhibitor associated musculoskeletal symptoms to participate in PA. © 2013 Wiley Periodicals, Inc.

Prevalence of work-related musculoskeletal symptoms of the neck and upper extremity among dentists in China.

PubMed

Feng, Beibei; Liang, Qi; Wang, Yuling; Andersen, Lars L; Szeto, Grace

2014-12-19

Studies from western countries show that dentists are vulnerable to work-related musculoskeletal disorders (WMSDs) of the neck and upper extremities, but little is known about their epidemiology among members of this rapidly growing profession in China. This study aims to investigate the prevalence of WMSDs and identify potential risk factors associated with their occurrence in the dental profession in China. A cross-sectional survey was carried out in 52 different hospitals in a large metropolitan city in China. A total of 304 questionnaires were distributed to respondents identified via stratified random sampling and 272 dentists (121 females and 151 males) completed the survey. The response rate was 89.5%. Visual analogue score was used to record neck and upper limb musculoskeletal symptoms on a body chart. Work-related risk factors, including physical and psychosocial factors, were accounted for in the regression analysis. 88% of the dentists reported at least one musculoskeletal disorder and 83.8% suffered from neck pain. In the multivariate analyses, working hours per day were associated with neck pain (OR=1.43; 95% CI 1.03 to 1.98). Inability to select the appropriate size of dental instrument was associated with shoulder (OR=2.07; 95% CI 1.00 to 4.32) and wrist/hand (OR=2.47; 95% CI 1.15 to 5.32) pain. As for psychosocial factors, high job demand was associated with symptoms in the shoulder (OR=1.09; 95% CI 1.00 to 1.18), elbow (OR=1.11; 95% CI 1.03 to 1.19) and wrist/hand (OR=1.09; 95% CI 1.02 to 1.17). Regular physical exercise was associated with decreased neck pain (OR=0.37; 95% CI 0.14 to 1.00). The prevalence of WMSDs among Chinese dentists is high. Specifically, long working hours, inability to select the appropriate size of dental instrument and high job demand are the most significant risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevalence and psychosocial risk factors of upper extremity musculoskeletal pain in industries of Taiwan: a nationwide study.

PubMed

Lee, Hsin-Yi; Yeh, Wen-Yu; Chen, Chun-Wan; Wang, Jung-Der

2005-07-01

Prevalence of upper extremity disorders and their associations with psychosocial factors in the workplace have received more attention recently. A national survey of cross-sectional design was performed to determine the prevalence rates of upper extremity disorders among different industries. Trained interviewers administered questionnaires to 17,669 workers and data on musculoskeletal complaints were obtained along with information on risk factors. Overall the 1-year prevalence of neck (14.8%), shoulder (16.6%), and hand (12.4%) disorders were higher than those of the upper back (7.1%) and elbow (8.3%) among those who sought medical treatment due to the complaint. Workers in construction and agriculture-related industries showed a higher prevalence of upper extremity disorders. After multiple logistic regression adjusted for age, education, and employment duration, we found job content, physical working condition, a harmonious interpersonal relationship at the workplace and organizational problems were significant determinants of upper extremity disorders in manufacturing and service industries. Male workers in manufacturing industries showed more concern about physical working conditions while female workers in public administration emphasized problems of job content and interpersonal relationships. We concluded that these factors were major job stressors contributing to musculoskeletal pain of the upper extremity.

The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: a prospective study.

PubMed

Brink, Yolandi; Crous, Lynette Christine; Louw, Quinette Abigail; Grimmer-Somers, Karen; Schreve, Kristiaan

2009-12-01

Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle (<34.75 degrees or >43.95 degrees; OR 2.8; 95% CI: 1.1-7.3) and a combination of extreme cervical and thoracic angles (<63.1 degrees or >71.1 degrees; OR 2.2; 95% CI: 1.1-5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9; 95% CI: 1.0-24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.

After-shift Musculoskeletal Disorder Symptoms in Female Workers and Work-related Factors: A Cross-sectional Study in a Seafood Processing Factory in Vietnam.

PubMed

Tran, Thuy Thi Thu; Phan, Chinh Thi Thuy; Pham, Tuan Cong; Nguyen, Quynh Thuy

2016-01-01

The seafood processing industry has been developing and providing marked contribution to Vietnam's economic growth in recent years. However, information on working conditions and their impacts to workers' health in this sector, focusing on musculoskeletal problems in female workers, has been poorly documented. This paper examines the prevalence of after-shift musculoskeletal disorder symptoms (A-MSDS) and work-related factors in female workers in a seafood processing factory in Vietnam. As part of a comprehensive study, a cross-sectional survey was implemented in one seafood processing factory in the center of Vietnam in 2014. A self-administered questionnaire was completed by 394 female workers to collect information about their A-MSDS state, demographic characteristics, health status and work conditions. Descriptive analysis and logistic regression were applied to describe and analyse the results. Nearly four-fifths of female workers experienced MSDs in at least one body part (77.7%) and 20.1% of them had MSDs in all investigated regions. The prevalence of A-MSDS in different body parts markedly varied, with the proportion of pain in the hips and lower extremities being as high as 53.3%, followed by pain in the shoulders and upper extremities (42.6%) and the neck (41.1%). A humid working environment, exposure to vibration and chemicals as well as taxing task demands and work organizations were found to significantly contribute to the increased risk of after-shift musculoskeletal disorders in female workers. Approximately 80% of female workers in the seafood processing factory experienced musculoskeletal pains after work, especially in the hips, extremities, neck and shoulders which were contributed by work conditions and task demands.

After-shift Musculoskeletal Disorder Symptoms in Female Workers and Work-related Factors: A Cross-sectional Study in a Seafood Processing Factory in Vietnam

PubMed Central

Tran, Thuy Thi Thu; Phan, Chinh Thi Thuy; Pham, Tuan Cong; Nguyen, Quynh Thuy

2016-01-01

Background The seafood processing industry has been developing and providing marked contribution to Vietnam's economic growth in recent years. However, information on working conditions and their impacts to workers' health in this sector, focusing on musculoskeletal problems in female workers, has been poorly documented. Objectives This paper examines the prevalence of after-shift musculoskeletal disorder symptoms (A-MSDS) and work-related factors in female workers in a seafood processing factory in Vietnam. Materials and Methods As part of a comprehensive study, a cross-sectional survey was implemented in one seafood processing factory in the center of Vietnam in 2014. A self-administered questionnaire was completed by 394 female workers to collect information about their A-MSDS state, demographic characteristics, health status and work conditions. Descriptive analysis and logistic regression were applied to describe and analyse the results. Results Nearly four-fifths of female workers experienced MSDs in at least one body part (77.7%) and 20.1% of them had MSDs in all investigated regions. The prevalence of A-MSDS in different body parts markedly varied, with the proportion of pain in the hips and lower extremities being as high as 53.3%, followed by pain in the shoulders and upper extremities (42.6%) and the neck (41.1%). A humid working environment, exposure to vibration and chemicals as well as taxing task demands and work organizations were found to significantly contribute to the increased risk of after-shift musculoskeletal disorders in female workers. Conclusion Approximately 80% of female workers in the seafood processing factory experienced musculoskeletal pains after work, especially in the hips, extremities, neck and shoulders which were contributed by work conditions and task demands. PMID:29546192

Psychometric Evaluation of the Workstyle Short Form among Nursing Assistants with Work-Related Musculoskeletal Symptoms.

PubMed

Cheung, Kin; Ching, Shirley S Y; Ma, Ka Yan; Szeto, Grace

2018-04-22

The Workstyle Short Form (24 items) (WSF-24) has been tested for its psychometric properties on work-related upper-extremity musculoskeletal symptoms (WRUEMSs) among office workers. However, the impact of workstyle should not only be limited to WRUEMSs and the sedentary workforce. The purpose of this study was to test the psychometric properties of the modified 24-item Chinese WSF (C-WSF-24) to identify work-related musculoskeletal symptoms (WRMSs) in various body parts among nursing assistants (NAs) working in nursing homes. Four hundred and thirty-nine NAs participated in the study. The results of the factor analysis were that a four-factor solution (working through pain, social reactivity at work, demands at work and breaks) accounted for 56.45% of the total variance. Furthermore, validation against known groups showed that the total score and subscale scores of the C-WSF-24 had the ability to discriminate between NAs with and without WRMSs in various body parts (such as low back and lower extremities). Additionally, C-WSF-24 had a statistically significant association with the contributing factors to WRMSs. This is the first study to examine the psychometric properties of the C-WSF-24 in the non-sedentary workforce, with a focus on various body parts of WRMSs. The results demonstrated that C-WSF-24 is reliable and valid for assessing WRMSs in various body parts among NAs.

Psychometric Evaluation of the Workstyle Short Form among Nursing Assistants with Work-Related Musculoskeletal Symptoms

PubMed Central

Ching, Shirley S. Y.; Ma, Ka Yan; Szeto, Grace

2018-01-01

The Workstyle Short Form (24 items) (WSF-24) has been tested for its psychometric properties on work-related upper-extremity musculoskeletal symptoms (WRUEMSs) among office workers. However, the impact of workstyle should not only be limited to WRUEMSs and the sedentary workforce. The purpose of this study was to test the psychometric properties of the modified 24-item Chinese WSF (C-WSF-24) to identify work-related musculoskeletal symptoms (WRMSs) in various body parts among nursing assistants (NAs) working in nursing homes. Four hundred and thirty-nine NAs participated in the study. The results of the factor analysis were that a four-factor solution (working through pain, social reactivity at work, demands at work and breaks) accounted for 56.45% of the total variance. Furthermore, validation against known groups showed that the total score and subscale scores of the C-WSF-24 had the ability to discriminate between NAs with and without WRMSs in various body parts (such as low back and lower extremities). Additionally, C-WSF-24 had a statistically significant association with the contributing factors to WRMSs. This is the first study to examine the psychometric properties of the C-WSF-24 in the non-sedentary workforce, with a focus on various body parts of WRMSs. The results demonstrated that C-WSF-24 is reliable and valid for assessing WRMSs in various body parts among NAs. PMID:29690544

Musculoskeletal symptoms and associated risk factors among office workers with high workload computer use.

PubMed

Cho, Chiung-Yu; Hwang, Yea-Shwu; Cherng, Rong-Ju

2012-09-01

Although the prevalence of reported discomfort by computer workers is high, the impact of high computer workload on musculoskeletal symptoms remains unclear. The purpose of this study was to investigate the prevalence of musculoskeletal symptoms for office workers with high computer workload. The association between risk factors and musculoskeletal symptoms was also assessed. Two questionnaires were posted on the Web sites of 3 companies and 1 university to recruit computer users in Tainan, Taiwan, during May to July 2009. The 12-item Chinese Health Questionnaire and Musculoskeletal Symptom Questionnaire were chosen as the evaluation tools for musculoskeletal symptoms and its associated risk factors. Chinese Health Questionnaire greater than 5 and computer usage greater than 7 h/d were used to as the cutoff line to divide groups. Descriptive statistics were computed for mean values and frequencies. χ(2) Analysis was used to determine significant differences between groups. A 0.05 level of significance of was used for statistical comparisons. A total of 254 subjects returned the questionnaire, of which 203 met the inclusion criteria. The 3 leading regions of musculoskeletal symptoms among the computer users were the shoulder (73%), neck (71%), and upper back (60%) areas. Similarly, the 3 leading regions of musculoskeletal symptoms among the computer users with high workload were shoulder (77.3%), neck (75.6%), and upper back (63.9%) regions. High psychologic distress was significantly associated with shoulder and upper back complaints (odds ratio [OR], 3.46; OR, 2.24), whereas a high workload was significantly associated with lower back complaints (OR, 1.89). Females were more likely to report shoulder complaints (OR, 2.25). This study found that high psychologic distress was significantly associated with shoulder and upper back pain, whereas high workload was associated with lower back pain. Women tended to have a greater risk of shoulder complaints than men. Developing an intervention that addresses both physical and psychologic problems is important for future studies. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Musculoskeletal disorder symptoms in correction officers: why do they increase rapidly with job tenure?

PubMed

Warren, Nicholas; Dussetschleger, Jeffrey; Punnett, Laura; Cherniack, Martin G

2015-03-01

In this study, we sought to explain the rapid musculoskeletal symptomatology increase in correction officers (COs). COs are exposed to levels of biomechanical and psychosocial stressors that have strong associations with musculoskeletal disorders (MSDs) in other occupations, possibly contributing to their rapid health deterioration. Baseline survey data from a longitudinal study of COs and manufacturing line workers were used to model musculoskeletal symptom prevalence and intensity in the upper (UE) and lower (LE) extremity. Outcomes were regressed on demographics and biomechanical and psychosocial exposures. COs reported significantly higher prevalence and intensity of LE symptoms compared to the industrial workers. In regression models, job tenure was a primary driver of CO musculoskeletal outcomes. In CO models, a single biomechanical exposure, head and arms in awkward positions, explained variance in both UE and LE prevalence (β of 0.338 and 0.357, respectively), and low decision latitude was associated with increased LE prevalence and intensity (β of 0.229 and 0.233, respectively). Manufacturing models were less explanatory. Examining demographic associations with exposure intensity, we found none to be significant in manufacturing, but in CO models, important psychosocial exposure levels increased with job tenure. Symptom prevalence and intensity increased more rapidly with job tenure in corrections, compared to manufacturing, and were related to both biomechanical and psychosocial exposures. Tenure-related increases in psychosocial exposure levels may help explain the CO symptom increase. Although exposure assessment improvements are proposed, findings suggest focusing on improving the psychosocial work environment to reduce MSD prevalence and intensity in corrections. © 2014, Human Factors and Ergonomics Society.

Thumb postures and physical loads during mobile phone use - a comparison of young adults with and without musculoskeletal symptoms.

PubMed

Gustafsson, Ewa; Johnson, Peter W; Hagberg, Mats

2010-02-01

The aim of this study was to evaluate thumb postures, thumb movements and muscle activity when using mobile phones for SMS messaging and to determine whether there were differences in these exposures (a) across various mobile phone tasks, (b) between gender and (c) between subjects with and without musculoskeletal symptoms in shoulders and upper extremities. Fifty-six young adults (15 healthy and 41 with musculoskeletal symptoms) performed a series of distinct tasks on a mobile phone. Muscular load in four forearm/hand muscles in the right arm and the right and left trapezius muscles were measured using electromyography (EMG). Thumb movements were registered using an electrogoniometer. The results showed that postures (sitting or standing) and the type of mobile phone task (holding the phone versus texting) affected muscle activity and thumb positions. Females compared to males had higher muscle activity in the extensor digitorum and the abductor pollicis longus when entering SMS messages and tended to have greater thumb abduction, higher thumb movement velocities and fewer pauses in the thumb movements. Subjects with symptoms had lower muscle activity levels in the abductor pollicis longus and tended to have higher thumb movement velocities and fewer pauses in the thumb movements compared to those without symptoms.

Evaluation of objectivity, reliability and criterion validity of the key indicator method for manual handling operations (KIM-MHO), draft 2007.

PubMed

Klußmann, André; Gebhardt, Hansjürgen; Rieger, Monika; Liebers, Falk; Steinberg, Ulf

2012-01-01

Upper extremity musculoskeletal symptoms and disorders are common in the working population. The economic and social impact of such disorders is considerable. Long-time, dynamic repetitive exposure of the hand-arm system during manual handling operations (MHO) alone or in combination with static and postural effort are recognised as causes of musculoskeletal symptoms and disorders. The assessment of these manual work tasks is crucial to estimate health risks of exposed employees. For these work tasks, a new method for the assessment of the working conditions was developed and a validation study was performed. The results suggest satisfying criterion validity and moderate objectivity of the KIM-MHO draft 2007. The method was modified and evaluated again. It is planned to release a new version of KIM-MHO in spring 2012.

Contrasting patterns of care for musculoskeletal disorders and injuries of the upper extremity and knee through workers' compensation and private health care insurance among union carpenters in Washington State, 1989 to 2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

2015-09-01

Musculoskeletal symptoms and disorders (MSDIs) are common reasons for visits to medical providers in the general population and they are common work-related complaints. Prior reports raise concerns as to whether declines in workers' compensation (WC) rates represent true improvement in occupational health and safety or shifting of care to other payment systems. By linking administrative records, we compared patterns of WC claims and private health care utilization for disorders of the upper extremity (UE) and knee among a large cohort of union carpenters over a 20-year period. As WC claim rates declined, private health care utilization increased. The increase was muted somewhat but sustained when adjusting for other patterns of health care utilization. Findings suggest the decline of WC claim rates do not solely represent improved occupational safety in this population, but also a considerable shifting of care to their private insurance coverage over time. © 2015 Wiley Periodicals, Inc.

Comparison of work-related musculoskeletal symptoms between male cameramen and male office workers.

PubMed

Jeong, Han-Seur; Suh, Byung-Seong; Kim, Soo-Geun; Kim, Won-Sool; Lee, Won-Cheol; Son, Kyung-Hun; Nam, Min-Woo

2018-01-01

Previous studies have classified cameramen's job as physiologically heavy work and identified the risk factors of work-related musculoskeletal disorders (WRMDs) in cameramen. However, those studies limited their research subjects to cameramen. In this study, we compared the frequency and severity of WRMDs between cameramen and office workers. A total of 293 subjects working in four broadcasting companies in Korea were recruited. A questionnaire survey was conducted for a month, starting in October 2016. The subjects were divided into cameramen and office workers according to their occupation. We compared the frequency and severity of WRMDs and ergonomic risk assessment results between the two groups. The high-risk WRMD group had a higher proportion of cameramen than office workers. Moreover, the high ergonomic risk group also had a higher proportion of cameramen than office workers for WRMDs in the upper extremities and waist+lower extremities. In the multivariable-adjusted model comparing cameramen and office workers, the odds ratio (OR) with 95% confidence interval (95% CI) for high-risk WRMDs was 3.50 (95% CI: 1.92-7.72) for the upper extremities and 3.18 (95% CI: 1.62-6.21) for the waist and the lower extremities. The ORs by body parts were 3.11 (95% CI: 1.28-7.57) for the neck, 3.90 (95% CI: 1.79-8.47) for the shoulders, and 4.23 (95% CI: 1.04-17.18) for the legs and feet. Our study suggests that cameramen are at high risk of WRMDs. Workplace improvements and management of the neck, shoulders, and lower extremities, which are susceptible to WRMDs, are necessary to prevent musculoskeletal disorders among cameramen.

Pressure pain thresholds and musculoskeletal morbidity in automobile manufacturing workers.

PubMed

Gold, Judith E; Punnett, Laura; Katz, Jeffrey N

2006-02-01

Reduced pressure pain thresholds (PPTs) have been reported in occupational groups with symptoms of upper extremity musculoskeletal disorders (UEMSDs). The purpose of this study was to determine whether automobile manufacturing workers (n=460) with signs and symptoms of UEMSDs had reduced PPTs (greater sensitivity to pain through pressure applied to the skin) when compared with unaffected members of the cohort, which served as the reference group. The association of PPTs with symptom severity and localization of PE findings was investigated, as was the hypothesis that reduced thresholds would be found on the affected side in those with unilateral physical examination (PE) findings. PPTs were measured during the workday at 12 upper extremity sites. A PE for signs of UEMSDs and symptom questionnaire was administered. After comparison of potential covariates using t tests, linear regression multivariable models were constructed with the average of 12 sites (avgPPT) as the outcome. Subjects with PE findings and/or symptoms had a statistically significant lower avgPPT than non-cases. AvgPPT was reduced in those with more widespread PE findings and in those with greater symptom severity (test for trend, P

A prospective study of musculoskeletal outcomes among manufacturing workers: II. Effects of psychosocial stress and work organization factors.

PubMed

Gerr, Fredric; Fethke, Nathan B; Anton, Dan; Merlino, Linda; Rosecrance, John; Marcus, Michele; Jones, Michael P

2014-02-01

The aim of this study was to characterize associations between psychosocial and work organizational risk factors and upper-extremity musculoskeletal symptoms and disorders. Methodological limitations of previous studies of psychosocial and work organizational risk factors and musculoskeletal outcomes have produced inconsistent associations. In this prospective epidemiologic study of 386 workers, questionnaires to assess decision latitude ("control") and psychological job demands ("demand") were administered to study participants and were used to classify them into job strain "quadrants". Measures of job stress and job change were collected during each week of follow-up. Incident hand/arm and neck/shoulder symptoms and disorders were ascertained weekly. Associations between exposure measures and musculoskeletal outcomes were estimated with proportional hazard methods. When compared to the low-demand/high-control job strain referent category, large increases in risk of hand/arm disorders were observed for both high-demand/high-control (hazard ratio [HR] = 4.49, 95% confidence interval [CI] = [1.23, 16.4]) and high-demand/low-control job strain categories (HR = 5.18,95% CI = [1.39, 19.4]). Similar associations were observed for hand/arm symptoms. A strong association was also observed between the low-demand/low-control job strain category and neck/shoulder disorders (HR = 6.46, 95% CI = [1.46, 28.6]). Statistically significant associations were also observed between weekly stress level and weekly job change and several musculoskeletal outcomes. Associations between psychosocial risk factors and work organizational factors and musculoskeletal outcomes were large and in the hypothesized direction. Prevention of occupational musculoskeletal disorders may require attention to psychosocial and work organizational factors in addition to physical factors. Methods to control adverse effects of psychosocial and work organizational risk factors should be explored.

The relationship among computer work, environmental design, and musculoskeletal and visual discomfort: examining the moderating role of supervisory relations and co-worker support.

PubMed

Robertson, Michelle M; Huang, Yueng-Hsiang; Larson, Nancy

2016-01-01

The prevalence of work-related upper extremity musculoskeletal disorders and visual symptoms reported in the USA has increased dramatically during the past two decades. This study examined the factors of computer use, workspace design, psychosocial factors, and organizational ergonomics resources on musculoskeletal and visual discomfort and their impact on the safety and health of computer work employees. A large-scale, cross-sectional survey was administered to a US manufacturing company to investigate these relationships (n = 1259). Associations between these study variables were tested along with moderating effects framed within a conceptual model. Significant relationships were found between computer use and psychosocial factors of co-worker support and supervisory relations with visual and musculoskeletal discomfort. Co-worker support was found to be significantly related to reports of eyestrain, headaches, and musculoskeletal discomfort. Supervisor relations partially moderated the relationship between workspace design satisfaction and visual and musculoskeletal discomfort. This study provides guidance for developing systematic, preventive measures and recommendations in designing office ergonomics interventions with the goal of reducing musculoskeletal and visual discomfort while enhancing office and computer workers' performance and safety.

Evaluation of the Risk for Work-Related Upper Extremity Musculoskeletal Symptoms in USAF Air Traffic Controllers: A Pilot Feasibility Study

DTIC Science & Technology

1997-07-11

interest to this study. One was suffering from (being diagnosed and in treatment for) medial epicondylitis , and the other had tenderness related to...rest forearms and hands, excessive lateral deviation of the hands operating the keyboard, and a pronounced inclination or turning of the head. Their...equal to or greater than 2.0. A similar relative risk was noted for neck, shoulder, arm and elbow disorders in 9 of 16 studies. The magnitude of the

Women, work and musculoskeletal health.

PubMed

Strazdins, Lyndall; Bammer, Gabriele

2004-03-01

Why are employed women at increased risk for upper limb musculoskeletal disorders and what can this tell us about the way work and family life shape health? Despite increases in women's labour force participation, gender differences in work-related health conditions have received little research attention. This appears be the first study to examine why employed women are much more likely than men to experience upper body musculoskeletal disorders. A mailed self-report survey gathered data from 737 Australian Public Service employees (73% women). The majority of respondents were clerical workers (73%). Eighty one per cent reported some upper body symptoms; of these, 20% reported severe and continuous upper body pain. Upper body musculoskeletal symptoms were more prevalent and more severe among women. The gender difference in symptom severity was explained by risk factors at work (repetitive work, poor ergonomic equipment), and at home (having less opportunity to relax and exercise outside of work). Parenthood exacerbated this gender difference, with mothers reporting the least time to relax or exercise. There was no suggestion that women were more vulnerable than men to pain, nor was there evidence of systematic confounding between perceptions of work conditions and reported health status. Changes in the nature of work mean that more and more employees, especially women, use computers for significant parts of their workday. The sex-segregation of women into sedentary, repetitive and routine work, and the persisting gender imbalance in domestic work are interlinking factors that explain gender differences in musculoskeletal disorders.

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees.

PubMed

Allami, Mostafa; Mousavi, Batool; Masoumi, Mehdi; Modirian, Ehsan; Shojaei, Hadi; Mirsalimi, Fatemeh; Hosseini, Maryam; Pirouzi, Pirouz

2016-01-01

Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees (206 amputations) from the Iran-Iraq war were evaluated, and a detailed questionnaire was also administered. The most common level of amputation was the finger or wrist level (108, 52.4 %). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis (65, 31.6 %), rotator cuff injury (24, 11.7 %), bicipital tendonitis (69, 33.5 %), shoulder drop (42, 20.4 %) and muscle atrophy (19, 9.2 %). Peripheral nerve disorders included carpal tunnel syndrome in 13 (6.3 %) and unilateral brachial plexus injury in 1 (1 %). Fifty-three (51.5 %) were diagnosed with facet joint syndrome at the level of the cervical spine (the most frequent site). Using a prosthesis was reported by 65 (63.1 %), both left and right sides. The back was the most common site of pain (71.8 %). The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

Understanding work related musculoskeletal pain: does repetitive work cause stress symptoms?

PubMed

Bonde, J P; Mikkelsen, S; Andersen, J H; Fallentin, N; Baelum, J; Svendsen, S W; Thomsen, J F; Frost, P; Kaergaard, A

2005-01-01

Pain in the neck and upper extremity is reported with high frequency in repetitive work. Mechanical overload of soft tissues seems a plausible mechanism, but psychological factors have received considerable attention during the past decade. If psychological factors are important for development of regional pain in repetitive work, stress symptoms would likely be on the causal path. To examine whether objective measures of repetitive monotonous work are related to occurrence and development of stress symptoms. In 1994-95, 2033 unskilled workers with continuous repetitive work and 813 workers with varied work were enrolled. Measures of repetitiveness and force requirements were quantified using video observations to obtain individual exposure estimates. Stress symptoms were recorded at baseline and after approximately one, two, and three years by the Setterlind Stress Profile Inventory. Repetitive work, task cycle time, and quantified measures of repetitive upper extremity movements including force requirements were not related to occurrence of stress symptoms at baseline or development of stress symptoms during three years of follow up. The findings do not indicate that repetitive work is associated with stress symptoms, but small effects cannot be ruled out. Thus the results question the importance of mental stress mechanisms in the causation of regional pain related to repetitive work. However, the findings should be interpreted with caution because the stress inventory has not been validated against a gold standard.

Depressive Symptoms, Anatomical Region, and Clinical Outcomes for Patients Seeking Outpatient Physical Therapy for Musculoskeletal Pain

PubMed Central

Coronado, Rogelio A.; Beneciuk, Jason M.; Valencia, Carolina; Werneke, Mark W.; Hart, Dennis L.

2011-01-01

Background Clinical guidelines advocate the routine identification of depressive symptoms for patients with pain in the lumbar or cervical spine, but not for other anatomical regions. Objective The purpose of this study was to investigate the prevalence and impact of depressive symptoms for patients with musculoskeletal pain across different anatomical regions. Design This was a prospective, associational study. Methods Demographic, clinical, depressive symptom (Symptom Checklist 90–Revised), and outcome data were collected by self-report from a convenience sample of 8,304 patients. Frequency of severe depressive symptoms was assessed by chi-square analysis for demographic and clinical variables. An analysis of variance examined the influence of depressive symptoms and anatomical region on intake pain intensity and functional status. Separate hierarchical multiple regression models by anatomical region examined the influence of depressive symptoms on clinical outcomes. Results Prevalence of severe depression was higher in women, in industrial and pain clinics, and in patients who reported chronic pain or prior surgery. Lower prevalence rates were found in patients older than 65 years and those who had upper- or lower-extremity pain. Depressive symptoms had a moderate to large effect on pain ratings (Cohen d=0.55–0.87) and a small to large effect on functional status (Cohen d=0.28–0.95). In multivariate analysis, depressive symptoms contributed additional variance to pain intensity and functional status for all anatomical locations, except for discharge values for the cervical region. Conclusions Rates of depressive symptoms varied slightly based on anatomical region of musculoskeletal pain. Depressive symptoms had a consistent detrimental influence on outcomes, except on discharge scores for the cervical anatomical region. Expanding screening recommendations for depressive symptoms to include more anatomical regions may be indicated in physical therapy settings. PMID:21233305

Examination and treatment of patients with unilateral vestibular damage, with focus on the musculoskeletal system: a case series.

PubMed

Wilhelmsen, Kjersti; Kvåle, Alice

2014-07-01

Persistent dizziness and balance problems have been reported in some patients with unilateral vestibular pathology. The purpose of this case series was to address the examination and treatment of musculoskeletal dysfunction in patients with unilateral vestibular hypofunction. The musculoskeletal system was evaluated with the Global Physiotherapy Examination, dynamic balance was measured during walking with triaxial accelerometers positioned on the lower and upper trunk, and symptoms and functional limitations were assessed with standardized self-report measures. The 4 included patients had symptoms of severe dizziness that had lasted more than 1 year after the onset of vestibular dysfunction and a moderate level of perceived disability. Musculoskeletal abnormalities typically included postural misalignment, restricted abdominal respiration, restricted trunk movements, and tense muscles of the upper trunk and neck. The patients attended a modified vestibular rehabilitation program consisting of body awareness exercises addressing posture, movements, and respiration. After the intervention, self-reported symptoms and perceived disability improved. Improvements in mobility and positive physical changes were found in the upper trunk and respiratory movements. The attenuation of mediolateral accelerations (ie, body oscillations) in the upper trunk changed; a relatively more stable upper trunk and a concomitantly more flexible lower trunk were identified during walking in 3 patients. The recovery process may be influenced by self-inflicted rigid body movements and behavior strategies that prevent compensation. Addressing physical dysfunction and enhancing body awareness directly and dizziness indirectly may help patients with unilateral vestibular hypofunction break a self-sustaining cycle of dizziness and musculoskeletal problems. Considering the body as a functional unit and including both musculoskeletal and vestibular systems in examination and treatment may be important. © 2014 American Physical Therapy Association.

Neither got a good bill of musculoskeletal health: a comparative study among medical and dental students.

PubMed

Coskun Benlidayi, Ilke; Al-Bayati, Zainb; Guzel, Rengin; Sarpel, Tunay

2018-06-06

It has been well established that musculoskeletal complaints are common among dentistry students. However, data regarding the comparison of overall musculoskeletal health between dental and medical students is scarce. The objective of the current study was to compare musculoskeletal health between medical and dental students. The population of the current study was comprised of fourth- and fifth-year students from medical and dental faculties of the same university who were at least three months in clinical training. Self-administered multi-item questionnaires regarding the musculoskeletal complaints were distributed to these students. A comparative analysis was carried out on the responses derived from the medical and dental students. A total of 219 students completed the questionnaire, yielding a response rate of 81.1%. Almost four fifth (80.4%) of the students reported musculoskeletal pain, with frequencies of 85.9 and 75.8% in dental and medical students, respectively (p > 0.05). Total, upper extremity and neck VAS scores were significantly higher in dental students than those in medical students (p < 0.01, p < 0.001 and p < 0.05, respectively). The rate of mild-severe pain sufferers in the upper extremity was also higher among dental students (p < 0.001). Musculoskeletal pain is frequent in both medical and dental students. However, the intensity of pain - particularly for the upper extremity and neck - is higher among dental students. The findings of the current study might be attributed to the fact that dental education requires more physical burden during routine clinical training than medical education.

Back and upper extremity disorders among enlisted U.S. Marines: burden and individual risk factors.

PubMed

Huang, G D; Feuerstein, M; Arroyo, F

2001-11-01

Although musculoskeletal disorders of the low back and upper extremities can affect military readiness, little is known about their extent and risk factors in the U.S. Marine Corps. Using the Defense Medical Epidemiology and Defense Medical Surveillance System databases, back and upper extremity diagnostic categories were among the top four sources of outpatient visits and duty limitation among enlisted Marines. Back disorders were also found to be the fifth most common cause for lost time. Subsequently, high-risk occupations were identified, age-related trends for clinic visit rates were determined, and rate ratios were computed for the top 15 low back and upper extremity diagnoses among enlisted Marines from 1997 through 1998. Occupational categories with the highest rates of musculoskeletal-related outpatient visits included image interpretation, auditing and accounting, disturbsing, surveillance/target acquisition, and aircraft launch equipment. Significantly increasing linear trends in rates across age groups were found for most diagnoses. For 1998, age-specific rate ratios indicated significantly higher rates for most low back and upper extremity disorders for females; lower rank (i.e., E1-E4) was also a risk, but for fewer diagnoses. The findings emphasize the need to identify modifiable (e.g., work-related, individual) risk factors and to develop focused primary and secondary prevention programs for musculoskeletal disorders in the Marine Corps. Subsequently, these efforts can assist in reducing associated effects, maximizing resource utilization, and enhancing operational readiness.

Expert consensus on facilitators and barriers to return-to-work following surgery for non-traumatic upper extremity conditions: a Delphi study.

PubMed

Peters, S E; Johnston, V; Ross, M; Coppieters, M W

2017-02-01

This Delphi study aimed to reach consensus on important facilitators and barriers for return-to-work following surgery for non-traumatic upper extremity conditions. In Round 1, experts ( n = 42) listed 134 factors, which were appraised in Rounds 2 and 3. Consensus (⩾85% agreement) was achieved for 13 facilitators (high motivation to return-to-work; high self-efficacy for return-to-work and recovery; availability of modified/alternative duties; flexible return-to-work arrangements; positive coping skills; limited heavy work exertion; supportive return-to-work policies; supportive supervisor/management; no catastrophic thinking; no fear avoidance to return-to-work; no fear avoidance to pain/activity; return to meaningful work duties; high job satisfaction) and six barriers (mood disorder diagnosis; pain/symptoms at more than one musculoskeletal site; heavy upper extremity exertions at work; lack of flexible return-to-work arrangements; lack of support from supervisor/management; high level of pain catastrophizing). Future prognostic studies are required to validate these biopsychosocial factors to further improve return-to-work outcomes. V.

Hang Them High: A Hands-Free Technique for Upper Extremity Limb Holding During Surgical Preparation.

PubMed

Aneja, Arun; Leung, Patrick; Marquez-Lara, Alejandro

Lifting and holding upper and lower limbs during the "prep and drape" portion of certain orthopaedic procedures exert strong forces on the holder and may lead to musculoskeletal disorders. To address these challenges during upper extremity procedures, this article describes a hand-free elevation and traction technique of the upper limbs during preoperative skin preparation with the use of items readily available within the operating room (OR). This technique is particularly useful for heavy or fractured limbs that may impose a physical challenge to lift and maintain in a stable position. Implementation of this technique reduces the risk to nurses, OR personnel, and caregivers of developing work-related musculoskeletal injuries while lifting and holding limbs in the orthopaedic OR.

The effect of over-commitment and reward on trapezius muscle activity and shoulder, head, neck, and torso postures during computer use in the field

PubMed Central

Bruno Garza, Jennifer L.; Eijckelhof, Belinda H.W.; Huysmans, Maaike A.; Catalano, Paul J.; Katz, Jeffrey N.; Johnson, Peter W.; van Dieen, Jaap H.; van der Beek, Allard J.; Dennerlein, Jack T.

2015-01-01

Background Because of reported associations of psychosocial factors and computer related musculoskeletal symptoms, we investigated the effects of a workplace psychosocial factor, reward, in the presence of over-commitment, on trapezius muscle activity and shoulder, head, neck, and torso postures during computer use. Methods We measured 120 office workers across four groups (lowest/highest reward/over-commitment), performing their own computer work at their own workstations over a 2 hour period. Results Median trapezius muscle activity (p=0.04) and median neck flexion (p=0.03) were largest for participants reporting simultaneously low reward and high over-commitment. No differences were observed for other muscle activities or postures. Conclusions These data suggest that the interaction of reward and over-commitment can affect upper extremity muscle activity and postures during computer use in the real work environment. This finding aligns with the hypothesized biomechanical pathway connecting workplace psychosocial factors and musculoskeletal symptoms of the neck and shoulder. PMID:23818000

Applications of biomechanics for prevention of work-related musculoskeletal disorders.

PubMed

Garg, Arun; Kapellusch, Jay M

2009-01-01

This paper summarises applications of biomechanical principles and models in industry to control musculoskeletal disorders of the low back and upper extremity. Applications of 2-D and 3-D biomechanical models to estimate compressive force on the low back, the strength requirements of jobs, application of guidelines for overhead work and application of strain index and threshold limit value to address distal upper extremity musculoskeletal disorders are presented. Several case studies applied in the railroad industry, manufacturing, healthcare and warehousing are presented. Finally, future developments needed for improved biomechanical applications in industry are discussed. The information presented will be of value to practising ergonomists to recognise how biomechanics has played a significant role in identifying causes of musculoskeletal disorders and controlling them in the workplace. In particular, the information presented will help practising ergonomists with how physical stresses can be objectively quantified.

Musculoskeletal Symptoms among Drivers of All-Terrain Vehicles

NASA Astrophysics Data System (ADS)

REHN, B.; BERGDAHL, I. A.; AHLGREN, C.; FROM, C.; JÄRVHOLM, B.; LUNDSTRÖM, R.; NILSSON, T.; SUNDELIN, G.

2002-05-01

The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeletal symptoms in the region of the neck, shoulders and upper and lower back for professional drivers of various categories of all-terrain vehicles and to assess the association between symptoms and duration of exposure to whole-body vibration (WBV) and shock from driving all-terrain vehicles. The study group consisted of 215 drivers of forest machines, 137 drivers of snowmobiles and 79 drivers of snowgroomers and a control group of 167 men randomly selected from the general population. The subjects were all from one of the four most northern counties in Sweden and they were all men. Musculoskeletal symptoms were assessed by use of a standardized questionnaire. In addition, the questionnaire held items about the driving time with all-terrain vehicles and a subjective estimation of exposure to unpleasant movements (shock, jolt, irregular sway). The job strain was measured according to Karasek's demands/control model. The prevalence ratios were adjusted for age, smoking and job strain. Among drivers, significantly increased prevalence ratios within the range of 1∂5-2·9 were revealed for symptoms from the neck-shoulder and thoracic regions during the previous year. None of the driver categories had a statistically significantly increased risk of low back pain. Forest vehicles were those most reported to cause unpleasant movements. In conclusion, drivers of all-terrain vehicles exhibit an increased risk of symptoms of musculoskeletal disorders in the neck-shoulder and thoracic regions. The increased risk is suggested to be related to physical factors such as exposure to whole-body vibration (WBV) and shock, static overload or extreme body postures. However, since symptoms of low back pain were not significantly increased, it appears that factors other than WBV would explain the occurrence of symptoms in the group of all-terrain drivers.

A systematic review of posture and psychosocial factors as contributors to upper quadrant musculoskeletal pain in children and adolescents.

PubMed

Prins, Yolandi; Crous, Lynette; Louw, Q A

2008-01-01

Musculoskeletal pain has become a major symptomatic complaint among children and adolescents and is increasingly occurring at a younger age. This systematic review was done to evaluate the evidence for the contribution of posture and psychosocial factors to the development of upper quadrant musculoskeletal pain in children and adolescents. The review describes the measurement tools used to assess musculoskeletal pain, sitting posture, and psychosocial factors. Two independent reviewers searched seven databases for observational studies that included prospective and cross-sectional study designs. Ten studies were extracted and assessed by two reviewers using the Critical Appraisal Form-Quantitative Studies (Law et al, 1998). The studies measured upper quadrant musculoskeletal pain as an outcome measure. Five studies evaluated sitting posture and found an association between the duration of static sitting and upper quadrant musculoskeletal pain. Six studies measured psychosocial factors of which depression, stress, and psychosomatic symptoms were the factors most commonly found to influence the development of upper quadrant musculoskeletal pain. The eligible studies used different pain measurement tools and different measurement tools to assess sitting posture and psychosocial factors. This review concludes that the duration of sitting posture and psychosocial factors may influence the experience of musculoskeletal pain among children and adolescents.

The prevalence of musculoskeletal problems and risk factors among women assembly workers in the semiconductor industry.

PubMed

Chandrasakaran, A; Chee, H L; Rampal, K G; Tan, G L

2003-12-01

A cross-sectional study to determine work-related musculoskeletal problems and ergonomic risk factors was conducted among 529 women semiconductor workers. Overall, 83.4% had musculoskeletal symptoms in the last one year. Pain in the back (57.8%), lower leg (48.4%) and shoulder (44.8%) were the three most common musculoskeletal problems. Significant associations were found between prolonged standing and upper and lower leg pain, between prolonged sitting and neck and shoulder pain and between prolonged bending and shoulder arm, back and upper leg pain. The study therefore showed a clear association between work-related musculoskeletal pain and prolonged hours spent in particular postures and movements.

Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

PubMed Central

2010-01-01

Background This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome). Methods A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed. Results A total of 22 studies (26 articles) fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work. Conclusions There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation. PMID:20429925

A Rasch-validated version of the upper extremity functional index for interval-level measurement of upper extremity function.

PubMed

Hamilton, Clayon B; Chesworth, Bert M

2013-11-01

The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0-100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity.

A Rasch-Validated Version of the Upper Extremity Functional Index for Interval-Level Measurement of Upper Extremity Function

PubMed Central

Chesworth, Bert M.

2013-01-01

Background The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation. Objective The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation. Design This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period. Methods Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated. Results A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0–100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1. Limitations Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance. Conclusion Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity. PMID:23813086

Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing.

PubMed

Wixted, Fiona; Shevlin, Mark; O'Sullivan, Leonard W

2018-03-15

As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders. Practitioners' Summary With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

PubMed

Swanberg, Jennifer; Clouser, Jessica Miller; Gan, Wenqi; Flunker, John C; Westneat, Susan; Browning, Steven R

2017-09-03

This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD. MSD was divided into tertiles; the upper tertile was defined as elevated. Multivariable Poisson regression revealed associations between any elevated MSD and longer tenure on horse farms, longer work hours, and poor safety climate. Elevated neck/back MSD was associated with longer tenure, longer work hours, and poor safety climate. Elevated upper extremity MSD was associated with age and poor safety climate. Elevated lower extremity MSD was associated with longer tenure, longer work hours, and being female. Musculoskeletal discomfort is common among these workers. Improving safety climate and minimizing long work hours is recommended.

Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia.

PubMed

Van, Leap; Chaiear, Naesinee; Sumananont, Chat; Kannarath, Chheng

2016-01-01

The main objectives of this cross-sectional descriptive study were to identify the prevalence of musculoskeletal symptoms and workstation biomechanical risk levels for garment workers in Kandal Province, Cambodia. This cross-sectional descriptive study used multistage sampling techniques to select 714 workers from three garment factories among 22 medium-size factories (250-1,000 workers). Face-to-face interviews and direct observation using the rapid upper limb assessment scale (RULA) were used to collect data. The response rate was 98.3% (702/714), and the majority (89.3%) of the respondents were female. Ninety-two percent (95% CI=90.0-94.0) of the workers reported musculoskeletal symptoms in at least one body region in the previous 12 months and 89.0% (95% CI=86.7-91.3) of the workers reported such symptoms in the past seven-day period. The neck, shoulder, and lower back were the most affected body regions. In addition, the RULA data showed that 81.2% of the workers' postures were rated as action level 3, indicating that investigation and change were required soon, and that 7.5% their postures were rated as action level 4, indicating that investigation and change were required immediately. Cambodian garment workers reported a high prevalence of musculoskeletal symptoms in upper body regions, and their workplaces were rated as high risk ergonomically.

Effects of vocationally oriented medical rehabilitation for aircraft maintenance personnel--a preliminary study of long-term effects with 5-year follow-up.

PubMed

Holopainen, Kaj; Nevala, Nina; Kuronen, Pentti; Arokoski, Jari P A

2004-12-01

Changes in the physical capacity, musculoskeletal symptoms, and perceived work ability of Finnish Air Force maintenance personnel were studied after vocationally oriented medical rehabilitation (VOMR). Twenty persons with chronic musculoskeletal symptoms in their back or neck took part in VOMR courses. The measurements were carried out at the beginning of the rehabilitation course and after two follow-up periods (0.5 and 5 years). The subjects worked most of the time in a bent position and often with their backs twisted and their arms above their shoulders. The severity of low-back pain and the number of days of sick leave decreased significantly (p < 0.05-0.01) during the 5-years follow-up. Also the exercise breaks at work increased (p < 0.01). After half a year of medical rehabilitation the measured range of the cervical spine and the dynamic and endurance strength of the upper and lower extremities was greater (p < 0.05-0.001) than at the beginning of the rehabilitation. There were no statistically significant differences in the use of physical therapy, experienced work strain, physical exercise or maximal oxygen consumption during the follow-up. This is a preliminary follow-up study lasting 5 years showed some significant changes in physical capacity, musculoskeletal symptoms and work ability. However, controlled studies are needed to evaluate these preliminary findings of this kind of rehabilitation model.

Upper-extremity phocomelia reexamined: a longitudinal dysplasia.

PubMed

Goldfarb, Charles A; Manske, Paul R; Busa, Riccardo; Mills, Janith; Carter, Peter; Ezaki, Marybeth

2005-12-01

In contrast to longitudinal deficiencies, phocomelia is considered a transverse, intercalated segmental dysplasia. Most patients demonstrate severe, but not otherwise classifiable, upper-extremity deformities, which usually cannot be placed into one of three previously described phocomelia groups. Additionally, these phocomelic extremities do not demonstrate true segmental deficits; the limb is also abnormal proximal and distal to the segmental defect. The purpose of this investigation was to present evidence that upper-extremity abnormalities in patients previously diagnosed as having phocomelia in fact represent a proximal continuum of radial or ulnar longitudinal dysplasia. The charts and radiographs of forty-one patients (sixty extremities) diagnosed as having upper-extremity phocomelia were reviewed retrospectively. On the basis of the findings on the radiographs, the disorders were categorized into three groups: (1) proximal radial longitudinal dysplasia, which was characterized by an absent proximal part of the humerus, a nearly normal distal part of the humerus, a completely absent radius, and a radial-sided hand dysplasia; (2) proximal ulnar longitudinal dysplasia, characterized by a short one-bone upper extremity that bifurcated distally and by severe hand abnormalities compatible with ulnar dysplasia; and (3) severe combined dysplasia, with type A characterized by an absence of the forearm segment (i.e., the radius and ulna) and type B characterized by absence of the arm and forearm (i.e., the hand attached to the thorax). Twenty-nine limbs in sixteen patients could be classified as having proximal radial longitudinal dysplasia. Systemic medical conditions such as thrombocytopenia-absent radius syndrome were common in those patients, but additional musculoskeletal conditions were rare. Twenty limbs in seventeen patients could be classified as having proximal ulnar longitudinal dysplasia. Associated musculoskeletal abnormalities, such as proximal femoral focal deficiency, were common in those patients. Eleven limbs in ten patients were identified as having severe combined dysplasia, which was type A in seven of them and type B in four. Four patients with severe combined dysplasia had congenital cardiac anomalies, and four had associated musculoskeletal abnormalities. Three of the four patients with the type-B disorder had a contralateral ulnar longitudinal dysplasia. We propose that cases previously classified as upper-extremity phocomelia represent a spectrum of severe longitudinal dysplasia, as none of the sixty extremities that we studied demonstrated a true intercalary deficiency. These findings have both developmental and genetic implications.

Safety, tolerability and effectiveness of an ergonomic intervention with chiropractic care for knowledge workers with upper-extremity musculoskeletal disorders: a prospective case series.

PubMed

Sherrod, Chuck; Johnson, Dale; Chester, Bruce

2014-01-01

One hundred and sixty million office workers (knowledge workers) in the U.S. and 2/3 of the developed countries use computers on a daily basis. Investigate the effectiveness of ergonomic and diversified chiropractic care for the reduction of pain, discomfort and impaired productivity in knowledge workers presenting with neck and upper extremity musculoskeletal complaints. A one-year prospective case series (n=5 applying ergonomic job task analyses and ongoing surveillance at baseline, 8 weeks, 16 weeks and one-year for musculoskeletal discomfort (CMDQ and VAS, quality of life (Rand SF-36, productivity and forward head posture (FHP). CMDQ and VAS scores decreased by 45% (neck) and 80% (upper extremities); productivity increased from 65% to 100%; physical functioning, role physical and role emotional improved for 4 of 5 subjects; body pain and general health improved for 3 of 5. Average FHP changed from 1-inch (baseline) to 1/4-inch (16-weeks) to 1/2-inch (one year). Effectiveness of this intervention for the reduction of risks depended upon the subject's adoption of safe workstyle behaviors and postures. A transtheoretical model (TTM) for behavior change is discussed as a possible methodology to enhance the adoption of safer work habits.

[Evidence of work-related musculo-skeletal disorders of the upper extremities and current methods of risk assessment: can Charlie Chaplin give us any suggestions in "modern times"].

PubMed

Apostoli, P; Sala, Emma

2009-01-01

in some sequences of the film "Modern Times" Chaplin is clearly involved in activities at high risk for work-related musculo-skeletal disorders of the upper extremities (UEWMSDs), but evidence and perception of any complaint are not evident. To evaluate the extent of the biomechanical risk using current risk assessment methods and discuss the possible reasons for lack of complaints. we made an analysis using six of the current methods for ergonomic risk assessment (State of Washington, check list OCRA, HAL by ACGIH, RULA Strain Index, OREGE). All the methods applied demonstrated high-to-very high levels of biomechanical risk for the upper extremities, with evident psychic effects but without apparent musculo-skeletal disorders. The discrepancy between evident psychological disorders ad apparent absence of UEWMSDs are discussed as being due to either: an artistic choice by Charlie Chaplin who focused on the aspects thought to be more immediately and easily comic; the short duration of the physical load exertion; or because of a different perception of muscular work and fatigue that was also typical until the 1970's and 1980's, which also confirmed the principles and practices of our preventive and medical disciplines at that time.

The impact of musculoskeletal pain on health-related quality of life in Fort Prajaksilapakom Hospital.

PubMed

Phongamwong, Chanwit; Mungkumpa, Ariya; Pawapootanon, Wimonsiri; Saiyotha, Duangtapha; Duangtapha, Chularat

2014-02-01

To investigate the prevalence of musculoskeletal pain and its impact on health-related quality of life (HRQoL) in workers of Fort Prajaksilapakom Hospital. A cross-sectional study was conducted. Participants completed self-reported questionnaires requesting demographic data and report ofpain symptoms occurring within the last one month. In addition, the HRQoL questionnaire (Thai SF-36v2) was used to study the SF-36v2 score. Musculoskeletal pain was divided into five groups: (1) no pain, 2) pain at one site, 3) pain at two sites, 4) pain at three sites and 5) pain at four sites. The association between the SF-36v2 score and mnusculoskeletal pain was evaluated using multivariable linear regression analysis. Of 726 hospital workers, 485 (66.8%) participated in the present study. The majority of participants were female (65.3%) and comprised non-health care providers (56.3%) with a mean age of 37 +/- 11.5 years (range: 20-59). The prevalence of musculoskeletal pain during the last one month was 77.0%. Musculoskeletal pain was mostly reported at the lower extremities (50.8%),followed by low back (48.2), the neck (40.5%) and the upper extremities (33.0%). Multiple sites pain (pain at more than one site) was 51%. Each subscale score of the Thai SF-36v2 was significantly lower in participants with pain than in those without pain (physical functioning; p<0.001, physical role; p = 0.001, bodily pain; p<0.001, general health; p<0.001, vitality; p<0.001, social functioning; p = 0.02, emotion role; p = 0.003 and mental health; p<0.001). Multiple pain sites were more likely to be associated with lower HRQoL. The present study showed the high prevalence of musculoskeletal pain and negative impact on HRQoL in workers ofFort Prajaksilapakom Hospital. The number of sites of musculoskeletal pain was associated with a reduction in the quality oflife.

Biopsychosocial influence on exercise-induced injury: genetic and psychological combinations are predictive of shoulder pain phenotypes.

PubMed

George, Steven Z; Parr, Jeffrey J; Wallace, Margaret R; Wu, Samuel S; Borsa, Paul A; Dai, Yunfeng; Fillingim, Roger B

2014-01-01

Chronic pain is influenced by biological, psychological, social, and cultural factors. The current study investigated potential roles for combinations of genetic and psychological factors in the development and/or maintenance of chronic musculoskeletal pain. An exercise-induced shoulder injury model was used, and a priori selected genetic (ADRB2, COMT, OPRM1, AVPR1 A, GCH1, and KCNS1) and psychological (anxiety, depressive symptoms, pain catastrophizing, fear of pain, and kinesiophobia) factors were included as predictors. Pain phenotypes were shoulder pain intensity (5-day average and peak reported on numerical rating scale), upper extremity disability (5-day average and peak reported on the QuickDASH), and shoulder pain duration (in days). After controlling for age, sex, and race, the genetic and psychological predictors were entered as main effects and interaction terms in separate regression models for the different pain phenotypes. Results from the recruited cohort (N = 190) indicated strong statistical evidence for interactions between the COMT diplotype and 1) pain catastrophizing for 5-day average upper extremity disability and 2) depressive symptoms for pain duration. There was moderate statistical evidence for interactions for other shoulder pain phenotypes between additional genes (ADRB2, AVPR1 A, and KCNS1) and depressive symptoms, pain catastrophizing, or kinesiophobia. These findings confirm the importance of the combined predictive ability of COMT with psychological distress and reveal other novel combinations of genetic and psychological factors that may merit additional investigation in other pain cohorts. Interactions between genetic and psychological factors were investigated as predictors of different exercise-induced shoulder pain phenotypes. The strongest statistical evidence was for interactions between the COMT diplotype and pain catastrophizing (for upper extremity disability) or depressive symptoms (for pain duration). Other novel genetic and psychological combinations were identified that may merit further investigation. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Instruments

PubMed Central

Adam, Garret; Wang, Kevin; Demaree, Christopher J.; Jiang, Jenny S.; Cheung, Mathew; Bechara, Carlos F.

2018-01-01

Thoracic outlet syndrome (TOS) is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST) and Upper Limb Tension Test (ULTT) were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG) tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%), viola (33%), and cello (27%). Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively (p = 0.03). Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects (p = 0.03). TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms. PMID:29370085

Reliability and Validity of the Musculoskeletal Tumor Society Scoring System for the Upper Extremity in Japanese Patients.

PubMed

Uehara, Kosuke; Ogura, Koichi; Akiyama, Toru; Shinoda, Yusuke; Iwata, Shintaro; Kobayashi, Eisuke; Tanzawa, Yoshikazu; Yonemoto, Tsukasa; Kawano, Hirotaka; Kawai, Akira

2017-09-01

The Musculoskeletal Tumor Society (MSTS) scoring system developed in 1993 is a widely used disease-specific evaluation tool for assessment of physical function in patients with musculoskeletal tumors; however, only a few studies have confirmed its reliability and validity. The aim of this study was to validate the MSTS scoring system for the upper extremity (MSTS-UE) in Japanese patients with musculoskeletal tumors for use by others in research. Does the MSTS-UE have: (1) sufficient reliability and internal consistency; (2) adequate construct validity; and (3) reasonable criterion validity in comparison to the Toronto Extremity Salvage Score (TESS) or SF-36? Reliability was performed using test-retest analysis, and internal consistency was evaluated with Cronbach's alpha coefficient. Construct validity was evaluated using a scree plot to confirm the construct number and the Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS-UE with the TESS and SF-36. The test-retest reliability with intraclass correlation coefficient (0.95; 95% CI, 0.91-0.97) was excellent, and internal consistency with Cronbach's α (0.7; 95% CI, 0.53-0.81) was acceptable. There were no ceiling and floor effects. The Akaike Information Criterion network showed that lifting ability, pain, and dexterity played central roles among the components. The MSTS-UE showed substantial correlation with the TESS scoring scale (r = 0.75; p < 0.001) and fair correlation with the SF-36 physical component summary (r = 0.37; p = 0.007). Although the MSTS-UE showed slight correlation with the SF-36 mental component summary, the emotional acceptance component of the MSTS-UE showed fair correlation (r = 0.29; p = 0.039). We can conclude that the MSTS is not an adequate measure of general health-related quality of life; however, this system was designed mainly to be a simple measure of function in a single extremity. To evaluate the mental state of patients with musculoskeletal tumors in the upper extremity, further study is needed.

Work-Related Musculoskeletal Symptoms and Job Factors Among Large-Herd Dairy Milkers.

PubMed

Douphrate, David I; Nonnenmann, Matthew W; Hagevoort, Robert; Gimeno Ruiz de Porras, David

2016-01-01

Dairy production in the United States is moving towards large-herd milking operations, resulting in an increase in task specialization and work demands. The objective of this project was to provide preliminary evidence of the association of a number of specific job conditions that commonly characterize large-herd parlor milking operations with work-related musculoskeletal symptoms (MSS). A modified version of the Standardized Nordic Questionnaire was administered to assess MSS prevalence among 450 US large-herd parlor workers. Worker demographics and MSS prevalences were generated. Prevalence ratios were also generated to determine associations of a number of specific job conditions that commonly characterize large-herd parlor milking operations with work-related MSS. Work-related MSS are prevalent among large-herd parlor workers, since nearly 80% report 12-month prevalences of one or more symptoms, which are primarily located in the upper extremities, specifically shoulders and wrist/hand. Specific large-herd milking parlor job conditions are associated with MSS in multiple body regions, including performing the same task repeatedly, insufficient rest breaks, working when injured, static postures, adverse environmental conditions, and reaching overhead. These findings support the need for administrative and engineering solutions aimed at reducing exposure to job risk factors for work-related MSS among large-herd parlor workers.

Association of individual and work-related risk factors with musculoskeletal symptoms among Iranian sewing machine operators.

PubMed

Dianat, Iman; Kord, Madeh; Yahyazade, Parvin; Karimi, Mohammad Ali; Stedmon, Alex W

2015-11-01

This cross-sectional study evaluated working conditions and the occurrence of self-reported musculoskeletal symptoms among 251 Iranian sewing machine operators. A questionnaire and direct observations of working postures using the rapid upper limb assessment (RULA) method were used. A high prevalence of musculoskeletal symptoms, particularly in the neck/shoulders, back and hands/wrists were found. The mean RULA grand score of 5.7 highlighted a poor sewing workstation design and indicated that most operators (with posture assessed at action level 3) needed an investigation and changes in their working habits soon. Work-related factors (including number of years worked as an operator, prolonged working hours per shift, long duration of sitting work without a break, feeling pressure due to work and working postures) and individual factors (including age, gender, BMI and regular sport/physical activities) were associated with musculoskeletal symptoms in multiple logistic regression models. The findings add to the understanding of working conditions of those jobs involving sewing activities and emphasise the need for ergonomic interventions to reduce musculoskeletal symptoms in the future. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The incidence of upper extremity injuries in endoscopy nurses working in the United States.

PubMed

Drysdale, Susan A

2013-01-01

Numerous studies have addressed musculoskeletal disorders in the international working population. The literature indicates that injuries exist at astounding rates with significant economic impact. Attempts have been made by government, private industry, and special interest groups to address the issues related to the occurrence and prevention of musculoskeletal injuries. Because of the limited research on the gastrointestinal (GI) endoscopy nursing sector, this descriptive, correlational study explored the incidence of upper extremity injuries in GI endoscopy nurses and technicians in the United States. A total of 215 subjects were included in the study. Findings show that upper extremity injuries exist among nurses working in GI endoscopy. Twenty-two percent of respondents missed work for upper extremity injuries. The findings also show that the severity of disability is related to the type of work done, type of assistive aids available at work, and whether or not ergonomic or physiotherapy assessments were provided at the place of employment. In reference to rate of injury and the availability of ergonomics and physiotherapy assessments, those who had ergonomic assessments available to them had scores on the Disabilities of the Arm, Shoulder, and Hand (DASH) inventory (indicating upper extremity disability) that were significantly lower (DASH score, 9.96) than those who did not have the assessments available (DASH score, 14.66). The results suggest that there are a significant number of subjects who are disabled to varying degrees and the majority of these are employed in full-time jobs.

Procedure-related musculoskeletal symptoms in gastrointestinal endoscopists in Korea

PubMed Central

Byun, Young Hye; Lee, Jun Haeng; Park, Moon Kyung; Song, Ji Hyun; Min, Byung-Hoon; Chang, Dong Kyung; Kim, Young-Ho; Son, Hee Jung; Rhee, Poong-Lyul; Kim, Jae J; Rhee, Jong Chul; Hwang, Ji Hye; Park, Dong Il; Shim, Sang Goon; Sung, In Kyung

2008-01-01

AIM: To determine the prevalence and risk factors of work-related musculoskeletal disorders in gastrointestinal endoscopists in Korea. METHODS: A survey of musculoskeletal symptoms, using a self-administered questionnaire, was conducted on 55 endoscopists practicing in general hospitals or health promotion centers. RESULTS: Forty-nine (89.1%) endoscopists reported musculoskeletal pain on at least one anatomic location and 37 (67.3%) endoscopists complained of pain at rest. Twenty-six (47.3%) endoscopists had severe musculoskeletal pain defined as a visual analogue score greater than 5.5. Factors related to the development of severe pain were (1) standing position during upper endoscopy, (2) specific posture/habit during endoscopic procedures, and (3) multiple symptomatic areas. Finger pain was more common in beginners, whereas shoulder pain was more common in experienced endoscopists. Sixteen percent of symptomatic endoscopists have modified their practice or reduced the number of endoscopic examinations. Only a few symptomatic endoscopists had sought professional consultation with related specialists. CONCLUSION: The prevalence of musculoskeletal pain in endoscopists is very high. The location of pain was different between beginners and experienced endoscopists. Measures for the prevention and adequate management of endoscopy-related musculoskeletal symptoms are necessary. PMID:18666326

Frequency of neck and shoulder pain and use of adjustable computer workstation among bankers

PubMed Central

Shabbir, Maryam; Rashid, Sajid; Umar, Bilal; Ahmad, Aqeel; Ehsan, Sarah

2016-01-01

Background & Objective: Neck and shoulder are the most susceptible areas for developing musculoskeletal symptoms among computer users. The modifiable risk factors for these work related musculoskeletal disorders include physical office environment and psychosocial work related factors. Computer workstation layout had been shown to be an important physical aspect of work environment that influences the upper quadrant symptoms. Our objective was to find the frequency of neck and shoulder pain and use of adjustable computer workstation among bankers of Islamabad/Rawalpindi/Multan Methods: A cross sectional study was conducted and 120 participants were questioned. Purposive sampling technique was used in this study. Maastricht Upper Extremity Questionnaire (MUEQ) was remodeled and important questions were extracted from its detailed version. The tool was then validated by taking expert opinion. Frequencies and percentages were calculated for categorical variables. Results: Pain in the neck during working hours was experienced by 71.67% of the respondents and 48.33% of the participants had experienced shoulder pain during working hours. Adjustable keyboards were used by 16.67% of respondents. Back care material was used by 40% bankers. Adjustable chairs were used by 95.83% of the participants. Only 3% of the bankers did not have chairs with adjustable heights. Chairs with adjustable armrests were used by 25% bankers. Conclusion: Neck and shoulder pain are common occurrences among bankers. Most of the components of workstations of bankers were adjustable but some of them still need attention. PMID:27182253

Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine.

PubMed

Ferracini, Gabriela N; Florencio, Lidiane L; Dach, Fabíola; Bevilaqua Grossi, Débora; Palacios-Ceña, María; Ordás-Bandera, Carlos; Chaves, Thais C; Speciali, José G; Fernández-de-Las-Peñas, César

2017-06-01

The role of musculoskeletal disorders of the cervical spine in migraine is under debate. To investigate differences in musculoskeletal impairments of the neck including active global and upper cervical spine mobility, the presence of symptomatic upper cervical spine joints, cervicocephalic kinesthesia and head/neck posture between women with episodic migraine, chronic migraine, and controls. A cross-sectional study. Tertiary university-based hospital. Fifty-five women with episodic migraine, 16 with chronic migraine, and 22 matched healthy women. Active cervical range of motion, upper cervical spine mobility (i.e., flexion-rotation test), referred pain from upper cervical joints, cervicocephalic kinesthesia (joint position sense error test, JPSE), and head/neck posture (i.e. the cranio-vertebral and cervical lordosis angles) were assessed by an assessor blinded to the subject's condition. Women with migraine showed reduced cervical rotation than healthy women (P=0.012). No differences between episodic and chronic migraine were found in cervical mobility. Significant differences for flexion-rotation test were also reported, suggesting that upper cervical spine mobility was restricted in both migraine groups (P<0.001). Referred pain elicited on manual examination of the upper cervical spine mimicking pain symptoms was present in 50% of migraineurs. No differences were observed on the frequency of symptomatic upper cervical joints between episodic and chronic migraine. No differences on JPSE or posture were found among groups (P>0.121). Women with migraine exhibit musculoskeletal impairments of the upper cervical spine expressed as restricted cervical rotation, decreased upper cervical rotation, and the presence of symptomatic upper cervical joints. No differences were found between episodic or chronic migraine. Identification treatment of the musculoskeletal impairments of the cervical spine may help to clinician for better management of patients with migraine.

Prevalence and Associated Factors of Musculoskeletal Disorders among Young Dentists in Indonesia.

PubMed

Phedy, P; Gatam, L

2016-07-01

Introduction: Musculoskeletal problems are often work related. Dentists have been reported to have a high prevalence of musculoskeletal problems. Dentists have to perform repetitive tasks, often in awkward and nonergonomic positions in their practice. Materials and Methods: This is a cross-sectional study. Five-hundred copies of Nordic Musculoskeletal Questionnaire were distributed to dentists who participated in a congress of a regional branch of the Indonesian Dentist Association. Data such as sex, length of practice, the presence of assistance, smoking, occupational stress, body mass index, hand dominance, and exercise were collected. Dentist who had practised for more than five years were excluded. Results: Two hundred and forty-one respondents fulfilled the research criteria. Musculoskeletal symptoms occurred in 63.5% respondents. Fatigue and pain were the most common manifestations of musculoskeletal symptoms among dentists (36.5 and 24.9% respectively). Prolonged sitting was the most common aggravating factor (26.6%) while exercise successfully relieved symptoms in 35.3% of respondents. Neck, upper back and lower back were the most common sites involved with prevalence of 25.7, 22.4, and 20.7% respectively. Neck was also the most common site of the symptoms preventing normal work during the preceding 12 months (8.3%). Exercise and stress are associated with the presence of musculoskeletal symptoms (p=0.01 and p<0.01 respectively). Exercise is associated with fatigue (p<0.01) and click (p<0.01), stress is associated with pain (p=0.00), stiffness (p=0.00), fatigue (p<0.01), and discomfort (p<0.01). Conclusions: The prevalence of musculoskeletal disorders in young dentists is 63.5%. Neck is the most common affected region. Stress and exercise are the main associated factor for musculoskeletal problems in dentists.

Biopsychosocial influence on exercise-induced injury: genetic and psychological combinations are predictive of shoulder pain phenotypes

PubMed Central

George, Steven Z.; Parr, Jeffrey J.; Wallace, Margaret R.; Wu, Samuel S.; Borsa, Paul A.; Dai, Yunfeng; Fillingim, Roger B.

2014-01-01

Chronic pain is influenced by biological, psychological, social, and cultural factors. The current study investigated potential roles for combinations of genetic and psychological factors in the development and/or maintenance of chronic musculoskeletal pain. An exercise-induced shoulder injury model was used and a priori selected genetic (ADRB2, COMT, OPRM1, AVPR1A, GCH1, and KCNS1) and psychological (anxiety, depressive symptoms, pain catastrophizing, fear of pain, and kinesiophobia) factors were included as predictors. Pain phenotypes were shoulder pain intensity (5-day average and peak reported on numerical rating scale), upper-extremity disability (5-day average and peak reported on the QuickDASH), and shoulder pain duration (in days). After controlling for age, sex, and race the genetic and psychological predictors were entered as main effects and interaction terms in separate regression models for the different pain phenotypes. Results from the recruited cohort (n = 190) indicated strong statistical evidence for interactions between the COMT diplotype and 1) pain catastrophizing for 5-day average upper-extremity disability and 2) depressive symptoms for pain duration. There was moderate statistical evidence for interactions for other shoulder pain phenotypes between additional genes (ADRB2, AVPR1A, and KCNS1) and depressive symptoms, pain catastrophizing, or kinesiophobia. These findings confirm the importance of the combined predictive ability of COMT with psychological distress, and reveal other novel combinations of genetic and psychological factors that may merit additional investigation in other pain cohorts. PMID:24373571

Trends in work-related musculoskeletal disorders: a comparison of risk factors for symptoms using quality of work life data from the 2002 and 2006 general social survey.

PubMed

Waters, Thomas R; Dick, Robert B; Krieg, Edward F

2011-09-01

To assess trends in risk factors for work-related musculoskeletal disorders (MSDs). Results from two similar national surveys (2002 and 2006) examined trends in relationships between individual, psychosocial, and physical factors and MSDs. Findings between years were similar, but important differences included a stronger effect of "Work Stress" on "Pain in Arms," and a stronger combined effect of "Hand Movement" and "Work Stress" on "Pain in Arms." Also, two interactions were statistically significant in the 2006 data, but not in the 2002 data, revealing potentially increased risks. These were "Hand Movement" and "Work Stress" on "Back Pain," and "Heavy Lifting" and "Work Stress" on "Pain in Arms." New strategies for preventing both low back and upper extremity MSDs should focus on work stress, heavy lifting, and hand movement, individually and in combination. (C)2011The American College of Occupational and Environmental Medicine

Musculoskeletal symptoms of the neck and shoulder among dental practitioners.

PubMed

Radanović, B; Vučinić, P; Janković, T; Mahmutović, E; Penjašković, D

2017-01-01

Musculoskeletal symptoms of the neck and shoulder represent a condition whose basic characteristic is pain. These conditions are very often present in dental health professionals. The aim of the paper was to determine presence of discomforts in areas of head, neck, shoulders, upper back and upper limbs at health professionals in area of dentistry, as well as discomfort localisation and methods of treatment. The research included 45 health professionals (dentists, dental assistants and dental technicians) employed at Dental Clinic of Vojvodina. The information was collected via questionnaire for analysis musculoskeletal disorders. Most of the dentists (75.9%) and the dental assistants (90.9%) as well as nearly half of the dental technicians (40%) experience discomforts in area of the neck, which are occasional, present in all three working positions and this discomforts are a little more frequent at women. The present musculoskeletal disorders are followed by headache, whose presence is statistically more significant compared to the other symptoms. The headache is usually located in the occipital part, it occurs individually or joined with other symptoms. Due to said discomforts the examinees in 59.4% of the cases don't contact the doctor. Medical therapy prevails in opposition to physical therapy. The discomforts deriving from the cervical part of the spine are present at great percentage of our examinees. Considering the fact that the said discomforts affect performing both professional and everyday activities, its prevention is necessary in order to avoid the consequences they carry.

Secondary prevention of work-related upper extremity disorders: recommendations from the Annapolis conference.

PubMed

Feuerstein, Michael; Harrington, Cherise B

2006-09-01

Efforts to improve the secondary prevention of work-related upper extremity (WRUE) symptoms continue to present a challenge. As with many occupational musculoskeletal pain disorders no single, direct cause-effect relationship exists among specific exposures, pathologic processes, and symptoms. The field has yet to create truly effective and efficient interventions for these problems that are based on current epidemiological and clinical knowledge. A working conference was held in Annapolis, Maryland on September 23rd and 24th, 2005 with leaders in research and application related to upper extremity disorders to address this challenge. The intent of the meeting was to review "state of the art" evidence in epidemiology and intervention research in order to develop suggestions regarding next steps in intervention research and application. On day 2 a number of stakeholders were present to discuss what they perceived as the missing pieces in both epidemiological research and applied intervention research in order to generate more effective workplace interventions. The papers in this series of the Journal of Occupational Rehabilitation indicate that scientifically sound progress has been made over the past decade in identifying ergonomic, workplace psychosocial, and individual factors in both the etiology and exacerbation of these symptoms/disorders. However, there is a gap between this knowledge and the development and practical implementation of comprehensive interventions for these problems. The conference also highlighted the paucity of economic analyses of the impact of these disorders as well as the economic study of the impact of intervention. Approaches for such evaluations were presented and are included in this special section of the journal. This series of papers and the summary of the invited group's discussions provided in this paper clearly emphasize the need for innovative ways to think about these problems and specific research topics that can help translate this knowledge into effective secondary prevention efforts.

Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

PubMed

Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

2014-11-01

Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Upper extremities and spinal musculoskeletal disorders and risk factors in students using computers

PubMed Central

Calik, Bilge Basakci; Yagci, Nesrin; Gursoy, Suleyman; Zencir, Mehmet

2014-01-01

Objective: To examine the effects of computer usage on the musculoskeletal system discomforts (MSD) of Turkish university students, the possible risk factors and study implications (SI). Methods: The study comprised a total of 871 students. Demographic information was recorded and the Student Specific Cornell Musculoskeletal Discomfort Questionnaire (SsCMDQ) was used to evaluate musculoskeletal system discomforts. Results: The neck, lower back and upper back areas were determined to be the most affected areas and percentages for SI were 21.6%, 19.3% and 16.3% respectively. Significant differences were found to be daily computer usage time for the lower back, total usage time for the neck, being female and below the age of 21 years (p<0.05) had an increased risk. Conclusions: The neck, lower back and upper back areas were found to be the most affected areas due to computer usage in university students. Risk factors for MSD were seen to be daily and total computer usage time, female gender and age below 21 years and these were deemed to cause study interference PMID:25674139

Job characteristics and musculoskeletal pain among shift workers of a poultry processing plant in Southern Brazil.

PubMed

Barro, Dânia; Olinto, Maria Teresa Anselmo; Macagnan, Jamile Block Araldi; Henn, Ruth Liane; Pattussi, Marcos Pascoal; Faoro, Mariana Wentz; Garcez, Anderson da Silva; Paniz, Vera Maria Vieira

2015-01-01

The purpose of this study was to evaluate the association between job characteristics and musculoskeletal pain among shift workers employed at a 24-hour poultry processing plant in Southern Brazil. This was a cross-sectional study of 1,103 production line workers aged 18-52 years. The job characteristics of interest were shift (day/night), shift duration, and plant sector ambient temperature. Musculoskeletal pain was defined as self-reported occupational-related pain in the upper or lower extremities and trunk, occurring often or always, during the last 12 months. The mean (SD) participant age was 30.8 (8.5) years, and 65.7% of participants were women. The prevalence of musculoskeletal pain was greater among female participants than male participants. After adjustment for job characteristics and potential confounders, the prevalence ratios (PR) of lower extremity musculoskeletal pain among female workers employed in extreme-temperature conditions those working the night shift, and those who had been working longer on the same shift were 1.75 (95% CI 1.12, 2.71), 1.69 (95% CI 1.05, 2.70), and 1.64 (95% CI 1.03, 2.62), respectively. In male workers, only extreme-temperature conditions showed a significant association with lower extremity musculoskeletal pain (PR=2.17; 95% CI 1.12, 4.22) after adjustment analysis. These findings suggest a need for implementation of measures to mitigate the damage caused by nighttime work and by working under extreme temperature conditions, especially among female shift workers, such as changing positions frequently during work and implementation of rest breaks and a workplace exercise program, so as to improve worker quality of life.

Workers' compensation claims for musculoskeletal disorders and injuries of the upper extremity and knee among union carpenters in Washington State, 1989-2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

2015-04-01

Numerous aspects of construction place workers at risk of musculoskeletal disorders and injuries (MSDIs). Work organization and the nature of MSDIs create surveillance challenges. By linking union records with workers' compensation claims, we examined 20-year patterns of MSDIs involving the upper extremity (UE) and the knee among a large carpenter cohort. MSDIs were common and accounted for a disproportionate share of paid lost work time (PLT) claims; UE MSDIs were three times more common than those of the knee. Rates declined markedly over time and were most pronounced for MSDIs of the knee with PLT. Patterns of risk varied by extremity, as well as by age, gender, union tenure, and predominant work. Carpenters in drywall installation accounted for the greatest public health burden. A combination of factors likely account for the patterns observed over time and across worker characteristics. Drywall installers are an intervention priority. © 2015 Wiley Periodicals, Inc.

Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity.

PubMed

Armijo-Olivo, Susan; Woodhouse, Linda J; Steenstra, Ivan A; Gross, Douglas P

2016-12-01

To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity. A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability. The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34). The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The effect of flooring on musculoskeletal symptoms in the lower extremities and low back among female nursing assistants.

PubMed

Wahlström, Jens; Ostman, Christina; Leijon, Ola

2012-01-01

This study examines the effect of changing the floor from a 2-mm homogenous vinyl floor to a 4-mm heterogeneous vinyl floor (1.5-mm wear layer and 2.5-mm foam layer) on musculoskeletal symptoms in the lower extremities and low back among nursing assistants in a geriatric care centre. A pre-post design with a reference group consisting of nursing assistants from a similar geriatric care centre was used. Follow-up measurements were carried out 12 and 24 months after the intervention by means of questionnaires. At the 1-year follow-up, the pain intensity score in the feet of the intervention group had decreased compared with the baseline value and remained statistically significant at the 2-year follow-up. The decrease in pain intensity score of the feet in the intervention group was statistically significantly different from the reference group, both after 1 and 2 years. The results show the importance of flooring in the workplace with regard to reducing musculoskeletal symptoms. Appropriate flooring is especially important in the female-dominated health care sector, where workers must stand or walk for long periods.

Biomechanical loading on the upper extremity increases from single key tapping to directional tapping.

PubMed

Qin, Jin; Trudeau, Matthieu; Katz, Jeffrey N; Buchholz, Bryan; Dennerlein, Jack T

2011-08-01

Musculoskeletal disorders associated with computer use span the joints of the upper extremity. Computing typically involves tapping in multiple directions. Thus, we sought to describe the loading on the finger, wrist, elbow and shoulder joints in terms of kinematic and kinetic difference across single key switch tapping to directional tapping on multiple keys. An experiment with repeated measures design was conducted. Six subjects tapped with their right index finger on a stand-alone number keypad placed horizontally in three conditions: (1) on single key switch (the number key 5); (2) left and right on number key 4 and 6; (3) top and bottom on number key 8 and 2. A force-torque transducer underneath the keypad measured the fingertip force. An active-marker infrared motion analysis system measured the kinematics of the fingertip, hand, forearm, upper arm and torso. Joint moments for the metacarpophalangeal, wrist, elbow, and shoulder joints were estimated using inverse dynamics. Tapping in the top-bottom orientation introduced the largest biomechanical loading on the upper extremity especially for the proximal joint, followed by tapping in the left-right orientation, and the lowest loading was observed during single key switch tapping. Directional tapping on average increased the fingertip force, joint excursion, and peak-to-peak joint torque by 45%, 190% and 55%, respectively. Identifying the biomechanical loading patterns associated with these fundamental movements of keying improves the understanding of the risks of upper extremity musculoskeletal disorders for computer keyboard users. Copyright © 2010 Elsevier Ltd. All rights reserved.

Musculoskeletal disorders and psychosocial risk factors among workers of the aircraft maintenance industry.

PubMed

Nogueira, Helen Cristina; Diniz, Ana Carolina Parise; Barbieri, Dechristian França; Padula, Rosimeire Simprini; Carregaro, Rodrigo Luiz; de Oliveira, Ana Beatriz

2012-01-01

During the recent decades Brazil has experienced an exponential growth in the aviation sector resulting in an increasing workforce. The aircraft maintenance industry stands out, where the workers have to handle different kind of objects. The aim of this study was to evaluate psychosocial indicators as well as musculoskeletal symptoms and disorders among aircraft maintenance workers. One hundred and one employees were evaluated (32.69 ± 8.25 yr, 79.8 ± 13.4 kg, and 1.75 ± 0.07 m). Musculoskeletal symptoms and disorders were assessed through the Nordic Musculoskeletal Questionnaire (NMQ) and a standardized physical examination. The Job Content Questionnaire (JCQ) and the Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial indicators. Results of the NMQ indicate the lower back as the most affected body region. On the other hand, the physical examination has shown clinical diagnosis of shoulder disorders. Neck, upper back and ankle/foot were also reported as painful sites. Most of workers have active work-demand profile and high work engagement levels. We suggest that musculoskeletal symptoms may be related to high biomechanical demand of the tasks performed by workers, what must be further investigated.

Functional measures developed for clinical populations identified impairment among active workers with upper extremity disorders

PubMed Central

Gardner, Bethany T.; Dale, Ann Marie; Buckner-Petty, Skye; Rachford, Robert; Strickland, Jaime; Kaskutas, Vicki; Evanoff, Bradley

2017-01-01

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work. PMID:26091980

Working Conditions in Carpet Weaving Workshops and Muscu-loskeletal Complaints among Workers in Tabriz - Iran

PubMed Central

Nazari, Jalil; Mahmoudi, Nader; Dianat, Iman; Graveling, Richard

2012-01-01

Background: Carpet weaving operations usualy involve poor working conditions that can lead to the development of musculoskeletal disorders (MSDs). This study investigated MSDs among car¬pet weavers in relation to working conditions from workers' view in Tabriz City, Northwest Iran. Methods: This cross-sectional and descriptive study was conducted in city of Tabriz, Iran. Data were col¬lected using interviews and questionnaires. The study population consisted of 200 randomly selected healthy weavers from twenty five active carpet weaving workshops. Results: The results showed a high prevalence of musculoskeletal problems among the study population. The most commonly affected body areas were neck, lower back, ankles/feet, hands/wrists, upper back, shoulders and knees, respectively. More than half of the weavers were not satisfied with the thermal con¬dition, noise level and cleanliness of the air in the workshops. The result indicated a significant relation¬ship between upper back symptoms and daily working time and between lower back symptoms and the numbers of rows of knots woven in a day. Weavers' satisfaction with hand tools shape and thermal condi¬tion of the workshops were associated with lower back symptoms, whereas satisfaction with weaving looms were associated with upper back complaints. Conclusion: The poor working condition of hand-woven carpet workshops such as environmental con¬ditions and work station design and tools should be the subject of ergonomics interventions. PMID:24688943

Musculoskeletal Pain in Gynecologic Surgeons

PubMed Central

Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

2013-01-01

Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

Statin Use and Musculoskeletal Pain Among Adults with and without Arthritis

PubMed Central

Buettner, Catherine; Rippberger, Matthew J.; Smith, Julie K.; Leveille, Suzanne G.; Davis, Roger B.; Mittleman, Murray A.

2011-01-01

BACKGROUND Musculoskeletal symptoms are common adverse effects of statins, yet little is known about the prevalence of musculoskeletal pain and statin use in the general population. METHODS We conducted a cross sectional study of the National Health and Nutrition Examination Survey (NHANES) 1999–2004. We estimated the prevalence of self-reported musculoskeletal pain according to statin use and calculated prevalence ratio estimates of musculoskeletal pain obtained from adjusted multiple logistic regression modeling. RESULTS Among 5,170 participants without arthritis, the unadjusted prevalence of musculoskeletal pain was significantly higher for statin users reporting pain in any region (23% among statin users, 95%CI: 19–27% compared to 18% among those not using statins, 95%CI: 17–20%; p=0.02) and in the lower extremities (12% among statin users, 95%CI: 8–16% compared to 8% among those not using statins, 95%CI: 7–9%; p=0.02). Conversely, among 3,058 participants with arthritis, statin use was not associated with higher musculoskeletal pain in any region. After controlling for confounders, among those without arthritis, statin use was associated with a significantly higher prevalence of musculoskeletal pain in any region, the lower back, and the lower extremities (adjusted prevalence ratios: 1.33 [1.06, 1.67]; 1.47 [1.02, 2.13]; 1.59 [1.12, 2.22], respectively). Among participants with arthritis, no association was observed between musculoskeletal pain and statin use on adjusted analyses. CONCLUSIONS In this population-based study, statin use was associated with a higher prevalence of musculoskeletal pain, particularly in the lower extremities, among individuals without arthritis. Evidence that statin use was associated with musculoskeletal pain among those with arthritis was lacking. PMID:22269621

Self-Reported Musculoskeletal Disorders of the Distal Upper Extremities and the Neck in German Veterinarians: A Cross-Sectional Study

PubMed Central

Kozak, Agnessa; Schedlbauer, Grita; Peters, Claudia; Nienhaus, Albert

2014-01-01

Background Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD), the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. Methods In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4%) veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. Results MSD in the neck (66.6%) and shoulder (60.5%) were more prevalent than in the hand (34.5%) or elbow (24.5%). Normal activities were affected in 28.7% (neck), 29.5% (shoulder), 19.4% (hand) and 14% (elbow) of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3%) or in the shoulder (10.8%). The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%). For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. Conclusion From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work. PMID:24586718

A study of surgeons' postural muscle activity during open, laparoscopic, and endovascular surgery.

PubMed

Szeto, G P Y; Ho, P; Ting, A C W; Poon, J T C; Tsang, R C C; Cheng, S W K

2010-07-01

Different surgical procedures impose different physical demands on surgeons and high prevalence rates of neck and shoulder pain have been reported among general surgeons. Past research has examined electromyography in surgeons mainly during simulated conditions of laparoscopic and open surgery but not during real-time operations and not for long durations. The present study compares the neck-shoulder muscle activities in three types of surgery and between different surgeons. The relationships of postural muscle activities to musculoskeletal symptoms and personal factors also are examined. Twenty-five surgeons participated in the study (23 men). Surface electromyography (EMG) was recorded in the bilateral cervical erector spinae, upper trapezius, and anterior deltoid muscles during three types of surgical procedures: open, laparoscopic, and endovascular. In each procedure, EMG data were captured for 30 min to more than 1 h. The surgeons were asked to rate any musculoskeletal symptoms before and after surgery. The present study showed significantly higher muscle activities in the cervical erector spinae and upper trapezius muscles in open surgery compared with endovascular and laparoscopic procedures. Muscle activities were fairly similar between endovascular and laparoscopic surgery. The upper trapezius usually has an important role in stabilizing both the neck and upper limb posture, and this muscle also recorded higher activities in open compared with laparoscopic and endovascular surgeries. Surgeons reported similar degrees of musculoskeletal symptoms in open and laparoscopic surgeries, which were higher than endovascular surgery. The present study showed that open surgery imposed significantly greater physical demands on the neck muscles compared with endovascular and laparoscopic surgeries. This may be due to the lighter manual task demands of these minimally invasive surgeries compared with open procedures, which generally required more dynamic movements and more forceful exertions.

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery.

PubMed

Hooper, M M; Stellato, T A; Hallowell, P T; Seitz, B A; Moskowitz, R W

2007-01-01

To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Longitudinal, interventional, unblended. Forty-eight obese subjects (47 women, one man, mean age 44+/-9 years; mean body mass index (BMI) 51+/-8 kg/m(2)) recruited from an academic medical center bariatric surgery program. Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 for quality of life. Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. SUBJECTS completed the SF-36 and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 on the WOMAC pain subscale score was evaluated. SF-36 outcomes were compared to normal published controls. Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41+/-15 kg and the mean BMI decreased from 51+/-8 to 36+/-7 kg/m(2). Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and only 37% did after weight loss. The WOMAC subscale and composite scores all improved significantly, as did the SF-36((R)). Change in BMI was the main factor impacting the WOMAC pain score. There was a higher frequency of multiple MSK complaints, including non-weight-bearing sites compared to historical controls, before surgery, which decreased significantly at most sites following weight loss and physical activity. These benefits may improve further, as weight loss may continue for up to 24 months. The benefits seen with weight loss indicate that prevention and treatment of obesity can improve MSK health and function.

Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

PubMed

Jensen, Jens Christian; Haahr, Jens Peder; Frost, Poul; Andersen, Johan Hviid

2013-10-01

Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period. This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender. High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.

Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

PubMed

Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

2012-01-01

Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ(2) = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

Musculoskeletal symptoms and exposure to whole-body vibration among open-pit mine workers in the Arctic.

PubMed

Burström, Lage; Aminoff, Anna; Björ, Bodil; Mänttäri, Satu; Nilsson, Tohr; Pettersson, Hans; Rintamäki, Hannu; Rödin, Ingemar; Shilov, Victor; Talykova, Ljudmila; Vaktskjold, Arild; Wahlström, Jens

2017-06-19

This cross-sectional questionnaire study was carried out at 4 open-pit mines in Finland, Norway, Russia and Sweden as part of the MineHealth project. The aim has been to compare the prevalence of musculoskeletal symptoms between drivers of mining vehicles and non-drivers. The mine workers were asked whether they had suffered from any musculoskeletal symptoms during the previous 12 months in specified body regions, and to grade the severity of these symptoms during the past month. They were also asked about their daily driving of mining vehicles. The questionnaire was completed by 1323 workers (757 vehicle drivers) and the reported prevalence and severity of symptoms were highest for the lower back, followed by pain in the neck, shoulder and upper back. Drivers in the Nordic mines reported fewer symptoms than non-drivers, while for Russian mine workers the results were the opposite of that. The daily driving of mining vehicles had no significant association with the risk of symptoms. Female drivers indicated a higher prevalence of symptoms as compared to male drivers. The study provided only weak support for the hypothesis that drivers of vehicles reported a higher prevalence of musculoskeletal symptoms than non-vehicle drivers. There were marked differences in the prevalence of symptoms among workers in various enterprises, even though the nature of the job tasks was similar. Int J Occup Med Environ Health 2017;30(4):553-564. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Neck-upper extremity musculoskeletal disorders among workers in the telecommunications company at Mansoura City.

PubMed

El-Bestar, Sohair Fouad; El-Mitwalli, Ashraf Abdel-Moniem; Khashaba, Eman Omar

2011-01-01

This study was to determine the prevalence and work-related risk factors of neck-upper extremity musculoskeletal disorders (MSDs) among video display terminal (VDT) users. A comparative cross-sectional study was conducted; there were 60 VDT users and 35 controls. The participants filled in a structured questionnaire, had electrophysiological tests and an X-ray of the neck. The prevalence of MSDs was higher (28.3%) among VDTs users compared to controls (14.3%) with no statistically significant difference. The prevalence of cervical disorders with or without radiculopathy (18.3%) was the most common disorder followed by carpal tunnel syndrome (6.6%). The mean (SD) age of MSD cases (51 ± 7.2 years) was statistically significantly higher than of the controls (42.8 ± 9). Physical exposure to prolonged static posture (OR: 6.9; 95% CI: 0.83-57.9), awkward posture (OR: 5.5; 95% CI: 0.6-46.4) and repetitive movements (OR: 5.5; 95% CI: 0.65-46.4) increased risk of MSDs with a statistically significant difference for static posture only (p < .05). VDT users experienced more job dissatisfaction, work-overload and limited social support from supervisors and colleagues. VDT use did not increase the risk of neck-upper extremity MSDs. The risk increased with older age and static posture.

[Musculoskeletal disorders among university student computer users].

PubMed

Lorusso, A; Bruno, S; L'Abbate, N

2009-01-01

Musculoskeletal disorders are a common problem among computer users. Many epidemiological studies have shown that ergonomic factors and aspects of work organization play an important role in the development of these disorders. We carried out a cross-sectional survey to estimate the prevalence of musculoskeletal symptoms among university students using personal computers and to investigate the features of occupational exposure and the prevalence of symptoms throughout the study course. Another objective was to assess the students' level of knowledge of computer ergonomics and the relevant health risks. A questionnaire was distributed to 183 students attending the lectures for second and fourth year courses of the Faculty of Architecture. Data concerning personal characteristics, ergonomic and organizational aspects of computer use, and the presence of musculoskeletal symptoms in the neck and upper limbs were collected. Exposure to risk factors such as daily duration of computer use, time spent at the computer without breaks, duration of mouse use and poor workstation ergonomics was significantly higher among students of the fourth year course. Neck pain was the most commonly reported symptom (69%), followed by hand/wrist (53%), shoulder (49%) and arm (8%) pain. The prevalence of symptoms in the neck and hand/wrist area was signifcantly higher in the students of the fourth year course. In our survey we found high prevalence of musculoskeletal symptoms among university students using computers for long time periods on a daily basis. Exposure to computer-related ergonomic and organizational risk factors, and the prevalence ofmusculoskeletal symptoms both seem to increase significantly throughout the study course. Furthermore, we found that the level of perception of computer-related health risks among the students was low. Our findings suggest the need for preventive intervention consisting of education in computer ergonomics.

Mechanical energy and power flow of the upper extremity in manual wheelchair propulsion.

PubMed

Guo, Lan-Yuen; Su, Fong-Chin; Wu, Hong-Wen; An, Kai-Nan

2003-02-01

To investigate the characteristics of mechanical energy and power flow of the upper limb during wheelchair propulsion. Mechanical energy and power flow of segments were calculated. Very few studies have taken into account the mechanical energy and power flow of the musculoskeletal system during wheelchair propulsion. Mechanical energy and power flow have proven to be useful tools for investigating locomotion disorders during human gait. Twelve healthy male adults (mean age, 23.5 years) were recruited for this study. Three-dimensional kinematic and kinetic data of the upper extremity were collected during wheelchair propulsion using a Hi-Res Expert Vision system and an instrumented wheel, respectively. During the initiation of the propulsion phase, joint power is generated in the upper arm or is transferred from the trunk downward to the forearm and hand to propel the wheel forward. During terminal propulsion, joint power is transferred upward to the trunk from the forearm and upper arm. The rate of change of mechanical energy and power flow for the forearm and hand have similar patterns, but the upper arm values differ. Joint power plays an important role in energy transfer as well as the energy generated and absorbed by muscles spanning the joints during wheelchair propulsion. Energy and power flow information during wheelchair propulsion allows us to gain a better understanding of the coordination of the movement by the musculoskeletal system.

A tailored workplace exercise program for women at risk for neck and upper limb musculoskeletal disorders: a randomized controlled trial.

PubMed

Rasotto, Chiara; Bergamin, Marco; Sieverdes, John C; Gobbo, Stefano; Alberton, Cristine L; Neunhaeuserer, Daniel; Maso, Stefano; Zaccaria, Marco; Ermolao, Andrea

2015-02-01

The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain. Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention. The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength. This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.

Occupational neck and shoulder pain among automobile manufacturing workers in Iran.

PubMed

Alipour, Akbar; Ghaffari, Mostafa; Shariati, Batoul; Jensen, Irene; Vingard, Eva

2008-05-01

Work-related musculoskeletal disorders (MSDs) of the upper extremities are a major problem globally, though most relevant studies have been reported from high income countries. The prevalence of neck and shoulder pain and its association with work-related physical and psychosocial factors and life style was determined by a cross-sectional survey using the Nordic Musculoskeletal Questionnaire (NMQ) in the largest Iranian car manufacturing company, with more than 18,000 employees. A total of 14,384 (79.8%) of all employees completed the questionnaire. Depending on the questions used to measure neck and shoulder symptoms, the prevalence varied widely (from 20.5% to 3.9%). In the multiple logistic regression model, limited to employees with at least 1 year of work experience, risk indicators for disabling pain of the neck and/or shoulder that remained for male were: duration of employment, high visual demands, repetitive work, sitting position at work, awkward working position, no regular exercise, monotonous work, lack of encouraging organizational culture, and anxiety concerning change. For female repetitive work, sitting position at work and no support if there is trouble at work were the only remaining factors. The study confirms the effects of physical and psychosocial factors on neck and shoulder symptoms among automobile manufacturing workers in a low to middle income country in spite of the relative youth and job insecurity of the population. (c) 2008 Wiley-Liss, Inc.

Survey of upper extremity injuries among martial arts participants.

PubMed

Diesselhorst, Matthew M; Rayan, Ghazi M; Pasque, Charles B; Peyton Holder, R

2013-01-01

To survey participants at various experience levels of different martial arts (MA) about upper extremity injuries sustained during training and fighting. A 21-s question survey was designed and utilised. The survey was divided into four groups (Demographics, Injury Description, Injury Mechanism, and Miscellaneous information) to gain knowledge about upper extremity injuries sustained during martial arts participation. Chi-square testing was utilised to assess for significant associations. Males comprised 81% of respondents. Involvement in multiple forms of MA was the most prevalent (38%). The hand/wrist was the most common area injured (53%), followed by the shoulder/upper arm (27%) and the forearm/elbow (19%). Joint sprains/muscle strains were the most frequent injuries reported overall (47%), followed by abrasions/bruises (26%). Dislocations of the upper extremity were reported by 47% of participants while fractures occurred in 39%. Surgeries were required for 30% of participants. Females were less likely to require surgery and more likely to have shoulder and elbow injuries. Males were more likely to have hand injuries. Participants of Karate and Tae Kwon Do were more likely to have injuries to their hands, while participants of multiple forms were more likely to sustain injuries to their shoulders/upper arms and more likely to develop chronic upper extremity symptoms. With advanced level of training the likelihood of developing chronic upper extremity symptoms increases, and multiple surgeries were required. Hand protection was associated with a lower risk of hand injuries. Martial arts can be associated with substantial upper extremity injuries that may require surgery and extended time away from participation. Injuries may result in chronic upper extremity symptoms. Hand protection is important for reducing injuries to the hand and wrist.

Prevalence of Musculoskeletal Symptoms Among Brazilian Merchant Navy Cadets: Differences Between Sexes and School Years.

PubMed

Lopes, Thiago J A; Simic, Milena; Bunn, Priscila Dos S; Terra, Bruno de S; Alves, Daniel de S; Ribeiro, Fabrício M; Rodrigues, Allan I; Lima, Maicom da S; Vilão, Patrick; Pappas, Evangelos

2017-11-01

Musculoskeletal disorders are common among military personnel, especially during the initial basic training period. Prior studies have reported the prevalence rate of overall musculoskeletal symptoms or injuries in different military population and nationalities, especially from North America and Europe; however, very limited information regarding the military population of South America exists. Although Brazil has one of the biggest military forces worldwide (≈335,000 military personnel), currently, to our knowledge, there is no study reporting musculoskeletal symptoms or injury statistics in the Brazilian Armed Forces. Thus, the aims of this study were to describe the 12-month prevalence rate of self-reported musculoskeletal symptoms in cadets and to compare this prevalence rate between sexes and school years. We conducted a cross-sectional study that took place from January to March 2016. Participants were Navy cadets, of both sexes and from three different school years of a Brazilian Merchant Navy Academy. All volunteers completed an adapted version of the Brazilian Nordic Musculoskeletal Questionnaire that assessed the past 12-month prevalence of musculoskeletal symptoms over eight body regions of the trunk and lower extremity. The Pearson's χ 2 test was conducted to compare prevalence of symptoms per body region between sexes and among the 3 school years. The study has been approved by the Naval Hospital's ethical committee. A total of 545 cadets (394 males), corresponding to 79% of all 688 cadets enrolled at the Merchant Navy Academy, volunteered to participate on this study. Among all cadets, 266 (49%) reported symptoms in at least one body region in the past 12-months. The knee with 116 (21%) and lower back with 96 (18%), were the most prevalent regions. In terms of sex differences, there was higher prevalence of symptoms among females 90 (60%) than males 176 (45%). Furthermore, females reported almost double the prevalence for lower back symptoms (27% vs. 14%, p = 0.001) and 11% higher prevalence of knee symptoms (29% vs. 18%, p = 0.006) than males. Finally, it is important to highlight that cadets from the second (127 [65%]) and third (77 [55%]) school years had higher prevalence of symptoms than cadets from the first year (62 [29%]). The knee and lower back were consistently the two most prevalent regions among all school years, but shin symptoms increased from 3% to 17% (p < 0.001) between the first and second school years. The prevalence of musculoskeletal symptoms in the Brazilian Merchant Navy Academy doubles between initial enrollment and the beginning of the second school year. Females have consistently higher rates of symptoms than males, particularly reporting higher prevalence of knee and lower back pain which are the two most prevalent regions in this population. Prevention efforts should concentrate on the basic training period in an attempt to decrease the prevalence of musculoskeletal symptoms in this population. Finally, prospective studies are required to verify the cause and effect relationship between training and musculoskeletal symptoms. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

A participatory approach to the study of lifting demands and musculoskeletal symptoms among Hong Kong workers

PubMed Central

Yeung, S; Genaidy, A; Deddens, J; Shoaf, C; Leung, P

2003-01-01

Aims: To investigate the use of a worker based methodology to assess the physical stresses of lifting tasks on effort expended, and to associate this loading with musculoskeletal outcomes (MO). Methods: A cross sectional study was conducted on 217 male manual handling workers from the Hong Kong area. The effects of four lifting variables (weight of load, horizontal distance, twisting angle, and vertical travel distance) on effort were examined using a linguistic approach (that is, characterising variables in descriptors such as "heavy" for weight of load). The numerical interpretations of linguistic descriptors were established. In addition, the associations between on the job effort and MO were investigated for 10 body regions including the spine, and both upper and lower extremities. Results: MO were prevalent in multiple body regions (range 12–58%); effort was significantly associated with MO in 8 of 10 body regions (odds ratios with age adjusted ranged from 1.31 for low back to 1.71 for elbows and forearm). The lifting task variables had significant effects on effort, with the weight of load having twice the effect of other variables; each linguistic descriptor was better described by a range of numerical values rather than a single numerical value. Conclusions: The participatory worker based approach on musculoskeletal outcomes is a promising methodology. Further testing of this approach is recommended. PMID:14504360

Health surveillance under adverse ergonomics conditions--validity of a screening method adapted for the occupational health service.

PubMed

Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

2015-01-01

A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders.

Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations

PubMed Central

Dennerlein, Jack T.; Hopcia, Karen; Sembajwe, Grace; Kenwood, Christopher; Stoddard, Anne M.; Tveito, T. Helene; Hashimoto, Dean M.; Sorensen, Glorian

2013-01-01

Background With the high prevalence of musculoskeletal disorders (MSDs) for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related MSDs. Methods We completed a cross-sectional survey of patient care workers (n=1572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations. Results Prevalence of self-reported musculoskeletal symptoms in the past 3-months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3-months, interference with work caused by this pain, symptom severity and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions, Conclusions Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings. PMID:22113975

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista.

PubMed

Stake, Seth; du Breuil, Anne L; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses.

Upper Extremity Deep Vein Thromboses: The Bowler and the Barista

PubMed Central

du Breuil, Anne L.; Close, Jeremy

2016-01-01

Effort thrombosis of the upper extremity refers to a deep venous thrombosis of the upper extremity resulting from repetitive activity of the upper limb. Most cases of effort thrombosis occur in young elite athletes with strenuous upper extremity activity. This article reports two cases who both developed upper extremity deep vein thromboses, the first being a 67-year-old bowler and the second a 25-year-old barista, and illustrates that effort thrombosis should be included in the differential diagnosis in any patient with symptoms concerning DVT associated with repetitive activity. A literature review explores the recommended therapies for upper extremity deep vein thromboses. PMID:27800207

Working postures of dental students: ergonomic analysis using the Ovako Working Analysis System and rapid upper limb assessment.

PubMed

Petromilli Nordi Sasso Garcia, Patrícia; Polli, Gabriela Scatimburgo; Campos, Juliana Alvares Duarte Bonini

2013-01-01

As dentistry is a profession that demands a manipulative precision of hand movements, musculoskeletal disorders are among the most common occupational diseases. This study estimated the risk of musculoskeletal disorders developing in dental students using the Ovako Working Analysis System (OWAS) and Rapid Upper Limb Assessment (RULA) methods, and estimated the diagnostic agreement between the 2 methods. Students (n = 75), enrolled in the final undergraduate year at the Araraquara School of Dentistry--UNESP--were studied. Photographs were taken of students while performing diverse clinical procedures (n = 283) using a digital camera, which were assessed using OWAS and RULA. A risk score was attributed following each procedure performed by the student. The prevalence of the risk of musculoskeletal disorders was estimated per point and for a 95% CI. To assess the agreement between the 2 methods, Kappa statistics with linear weighting were used. The level of significance adopted was 5%. There was a high prevalence of the mean score for risk of musculoskeletal disorders in the dental students evaluated according to the OWAS method (p = 97.88%; 95% CI: 96.20-99.56%), and a high prevalence of the high score (p = 40.6; 95% CI: 34.9-46.4%) and extremely high risk (p = 59.4%; 95% CI: 53.6-65.1%) according to RULA method Null agreement was verified (k = 0) in the risk di agnosis of the tested methods. The risk of musculoskeletal disorders in dental students estimated by the OWAS method was medium, whereas the same risk by the RULA method was extremely high. There was no diagnostic agreement between the OWAS and RULA methods.

Review of applicability of existing functional status measures to the study of workers with musculoskeletal disorders of the neck and upper limb.

PubMed

Stock, S R; Cole, D C; Tugwell, P; Streiner, D

1996-06-01

Both epidemiologic studies of the factors that contribute to the development of work-related musculoskeletal disorders of the neck and upper limb and intervention studies that test the effectiveness of workplace ergonomic and organizational changes are needed to provide empiric evidence for preventive strategies. This study reviews the relevance and comprehensiveness of existing functional status instruments for epidemiologic studies of work-related neck and upper limb disorders. Twelve domains were identified as the major areas of life affected by workers' neck and upper extremity disorder(s): work, household and family responsibilities, self-care, transportation/driving, sexual activity, sleep, social activities, recreational activities, mood, self-esteem, financial effects, and iatrogenic effects of assessments and treatment. Fifty-two functional status instruments were identified. Of these, 21 met the specified criteria as potentially relevant and were rated on the 3-point scale for relevance and comprehensiveness for each domain. None of the instruments covered all 12 domains adequately.

Questionnaires in Identifying Upper Extremity Function and Quality of Life After Treatment in Patients With Breast Cancer

ClinicalTrials.gov

2017-04-11

Musculoskeletal Complication; Recurrent Breast Carcinoma; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Therapy-Related Toxicity

Inter-rater reliability of PATH observations for assessment of ergonomic risk factors in hospital work.

PubMed

Park, Jung-Keun; Boyer, Jon; Tessler, Jamie; Casey, Jeffrey; Schemm, Linda; Gore, Rebecca; Punnett, Laura

2009-07-01

This study examined the inter-rater reliability of expert observations of ergonomic risk factors by four analysts. Ten jobs were observed at a hospital using a newly expanded version of the PATH method (Buchholz et al. 1996), to which selected upper extremity exposures had been added. Two of the four raters simultaneously observed each worker onsite for a total of 443 observation pairs containing 18 categorical exposure items each. For most exposure items, kappa coefficients were 0.4 or higher. For some items, agreement was higher both for the jobs with less rapid hand activity and for the analysts with a higher level of ergonomic job analysis experience. These upper extremity exposures could be characterised reliably with real-time observation, given adequate experience and training of the observers. The revised version of PATH is applicable to the analysis of jobs where upper extremity musculoskeletal strain is of concern.

Evidence of educational inadequacies in region-specific musculoskeletal medicine.

PubMed

Day, Charles S; Yeh, Albert C

2008-10-01

Recent studies suggest US medical schools are not effectively addressing musculoskeletal medicine in their curricula. We examined if there were specific areas of weakness by analyzing students' knowledge of and confidence in examining specific anatomic regions. A cross-sectional survey study of third- and fourth-year students at Harvard Medical School was conducted during the 2005 to 2006 academic year. One hundred sixty-two third-year students (88% response) and 87 fourth-year students (57% response) completed the Freedman and Bernstein cognitive mastery examination in musculoskeletal medicine and a survey eliciting their clinical confidence in examining the shoulder, elbow, hand, back, hip, knee, and foot on a one to five Likert scale. We specifically analyzed examination questions dealing with the upper extremity, lower extremity, back, and others, which included more systemic conditions such as arthritis, metabolic bone diseases, and cancer. Students failed to meet the established passing benchmark of 70% in all subgroups except for the others category. Confidence scores in performing a physical examination and in generating a differential diagnosis indicated students felt below adequate confidence (3.0 of 5) in five of the seven anatomic regions. Our study provides evidence that region-specific musculoskeletal medicine is a potential learning gap that may need to be addressed in the undergraduate musculoskeletal curriculum.

Prognostic factors for duration of sickness absence due to musculoskeletal disorders.

PubMed

Lötters, Freek; Burdorf, Alex

2006-02-01

The purpose of this prospective cohort study with 1-year follow-up was to determine prognostic factors for duration of sickness absence due to musculoskeletal disorders. Workers were included when on sickness absence of 2 to 6 weeks due to musculoskeletal disorders. A self-administered questionnaire was used to collect personal and work-related factors, pain, functional disability, and general health perceptions. Statistical analysis was done with Cox proportional hazard regression with an interaction variable with time for every risk factor of interest. Univariate and multivariate analyses were performed on musculoskeletal disorders and, separately, for low back pain. The main factors that were associated with longer sickness absence were older age, gender, perceived physical workload, and poorer general health for neck, shoulder and upper extremity disorders, and functional disability, sciatica, worker's own perception of the ability of return to work, and chronic complaints for low back pain. Workers with a high perceived physical work load returned to work increasingly slower over time than expected, whereas workers with a high functional disability returned to work increasingly faster over time. High pain intensity is a major prognostic factor for duration of sickness absence, especially in low back pain. The different disease-specific risk profiles for prolonged sickness absence indicate that low back pain and upper extremity disorders need different approaches when applying intervention strategies with the aim of early return to work. The interaction of perceived physical workload with time suggests that perceived physical workload would increasingly hamper return to work and, hence, supports the need for workplace interventions among workers off work for prolonged periods.

Development of a Pamphlet Targeting Computer Workstation Ergonomics

NASA Technical Reports Server (NTRS)

Faraci, Jennifer S.

1997-01-01

With the increased use of computers throughout Goddard Space Flight Center, the Industrial Hygiene Office (IHO) has observed a growing trend in the number of health complaints attributed to poor computer workstation setup. A majority of the complaints has centered around musculoskeletal symptoms, including numbness, pain, and tingling in the upper extremities, shoulders, and neck. Eye strain and headaches have also been reported. In some cases, these symptoms can lead to chronic conditions such as repetitive strain injuries (RSI's). In an effort to prevent or minimize the frequency of these symptoms among the GSFC population, the IHO conducts individual ergonomic workstation evaluations and ergonomics training classes upon request. Because of the extensive number of computer workstations at GSFC, and the limited amount of manpower which the Industrial Hygiene staff could reasonably allocate to conduct workstation evaluations and employee training, a pamphlet was developed with a two-fold purpose: (1) to educate the GSFC population about the importance of ergonomically-correct computer workstation setup and the potential effects of a poorly configured workstation; and (2) to enable employees to perform a general assessment of their own workstations and make any necessary modifications for proper setup.

Descriptive Epidemiology of Musculoskeletal Injuries in Naval Special Warfare Sea, Air, and Land Operators.

PubMed

Lovalekar, Mita; Abt, John P; Sell, Timothy C; Wood, Dallas E; Lephart, Scott M

2016-01-01

The purpose of this analysis was to describe medical chart reviewed musculoskeletal injuries among Naval Special Warfare Sea, Air, and Land Operators. 210 Operators volunteered (age: 28.1 ± 6.0 years, height: 1.8 ± 0.1 m, weight: 85.4 ± 9.3 kg). Musculoskeletal injury data were extracted from subjects' medical charts, and injuries that occurred during 1 year were described. Anatomic location of injury, cause of injury, activity when injury occurred, and injury type were described. The frequency of injuries was 0.025 per Operator per month. Most injuries involved the upper extremity (38.1% of injuries). Frequent anatomic sublocations for injuries were the shoulder (23.8%) and lumbopelvic region of the spine (12.7%). Lifting was the cause of 7.9% of injuries. Subjects were participating in training when 38.1% of injuries occurred and recreational activity/sports when 12.7% of injuries occurred. Frequent injury types were strain (20.6%), pain/spasm/ache (19.0%), fracture (11.1%), and sprain (11.1%). The results of this analysis underscore the need to investigate the risk factors, especially of upper extremity and physical activity related injuries, in this population of Operators. There is a scope for development of a focused, customized injury prevention program, targeting the unique injury profile of this population. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Health surveillance under adverse ergonomics conditions – validity of a screening method adapted for the occupational health service

PubMed Central

Jonker, Dirk; Gustafsson, Ewa; Rolander, Bo; Arvidsson, Inger; Nordander, Catarina

2015-01-01

A new health surveillance protocol for work-related upper-extremity musculoskeletal disorders has been validated by comparing the results with a reference protocol. The studied protocol, Health Surveillance in Adverse Ergonomics Conditions (HECO), is a new version of the reference protocol modified for application in the Occupational Health Service (OHS). The HECO protocol contains both a screening part and a diagnosing part. Sixty-three employees were examined. The screening in HECO did not miss any diagnosis found when using the reference protocol, but in comparison to the reference protocol considerable time savings could be achieved. Fair to good agreement between the protocols was obtained for one or more diagnoses in neck/shoulders (86%, k = 0.62) and elbow/hands (84%, k = 0.49). Therefore, the results obtained using the HECO protocol can be compared with a reference material collected with the reference protocol, and thus provide information of the magnitude of disorders in an examined work group. Practitioner Summary: The HECO protocol is a relatively simple physical examination protocol for identification of musculoskeletal disorders in the neck and upper extremities. The protocol is a reliable and cost-effective tool for the OHS to use for occupational health surveillance in order to detect workplaces at high risk for developing musculoskeletal disorders. PMID:25761380

[Risks and health problems caused by the use of video terminals].

PubMed

Tamez González, Silvia; Ortiz-Hernández, Luis; Martínez-Alcántara, Susana; Méndez-Ramírez, Ignacio

2003-01-01

To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.

Assessment of upper limb musculoskeletal pain and posture in workers of packaging units of pharmaceutical industries.

PubMed

Labbafinejad, Yasser; Danesh, Hossein; Imanizade, Zahra

2017-01-01

Work-related musculoskeletal disorders are defined as the disabling or painful injury to the muscles, nerves or tendons that are caused by work or aggravated by it. Some studies confirm the association between working in packaging units in various industries and the pain in the upper limb, but also there are controversies about the possible risk factors among different working populations. The present study aims to define the potential ergonomic risk factors for musculoskeletal pain in the upper limb. The Nordic Musculoskeletal Questionnaire was used for assessment of the musculoskeletal pain. Some other questions about the possible risk factors were included in the questionnaire. In order to assess posture, rapid upper limb assessment (RULA) test was performed by trained ergonomists. The findings of the study reveals that shoulder pain is associated with work history (P-value = 0.01), smoking (P-value = 0.02), the level of education (P-value = 0.04) and age more than 40 years old (P-value = 0.01). Wrist pain was associated with shiftwork (P-value = 0.04) and especially fixed shiftwork (P-value = 0.04) and also age more than 40(P-value = 0.03) and missed days from work with a cut point of 7 days (P-value = 0.03). After regression, only the work history (OR = 14.4 for 10 to 20 years and OR = 32.2 for more than 20 years) and shiftwork (OR = 2.35) remained statistically significant. In this study, RULA was not associated with symptoms in the upper limb in non-heavy working industries so we do not recommend it for screening purposes. The use of decades of working history and shiftwork can be considered for this purpose in the shoulder and wrist pain respectively.

Factors affecting the musculoskeletal disorders of workers in the frozen food manufacturing factories in Thailand.

PubMed

Thetkathuek, Anamai; Meepradit, Parvena; Jaidee, Wanlop

2016-01-01

The purpose of this research was to study factors affecting musculoskeletal disorders. The sample population of the study was 528 factory workers from the frozen food industry, as well as a controlled group of 255 office workers. The samples were collected during interviews using the Nordic questionnaire to assess musculoskeletal disorders, and to assess the risk by the rapid upper limb assessment and rapid entire body assessment techniques. The findings of the study were that most symptoms were found in the dissecting department, higher than in the controlled group. The details of the symptoms were, accordingly: elbow pain (adjusted odds ratio, 35.1; 95% CI [17.4, 70.9]). Regarding the risk of alcohol drinking, workers were exposed to more risks when alcohol was consumed. It is suggested that workers' health should be monitored regularly. People who work in a cold environment should be encouraged to wear body protection and to avoid drinking.

The effectiveness of manual therapy for the management of musculoskeletal disorders of the upper and lower extremities: a systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

PubMed

Southerst, Danielle; Yu, Hainan; Randhawa, Kristi; Côté, Pierre; D'Angelo, Kevin; Shearer, Heather M; Wong, Jessica J; Sutton, Deborah; Varatharajan, Sharanya; Goldgrub, Rachel; Dion, Sarah; Cox, Jocelyn; Menta, Roger; Brown, Courtney K; Stern, Paula J; Stupar, Maja; Carroll, Linda J; Taylor-Vaisey, Anne

2015-01-01

Musculoskeletal disorders (MSDs) of the upper and lower extremities are common in the general population and place a significant burden on the health care system. Manual therapy is recommended by clinical practice guidelines for the management of these injuries; however, there is limited evidence to support its effectiveness. The purpose of our review was to investigate the effectiveness of manual therapy in adults or children with MSDs of the upper or lower extremity. Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of manual therapy were eligible. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best-evidence synthesis principles. Where available, we computed mean changes between groups, relative risks and 95 % CI. We screened 6047 articles. Seven RCTs were critically appraised and three had low risk of bias. For adults with nonspecific shoulder pain of variable duration, cervicothoracic spinal manipulation and mobilization in addition to usual care may improve self-perceived recovery compared to usual care alone. For adults with subacromial impingement syndrome of variable duration, neck mobilization in addition to a multimodal shoulder program of care provides no added benefit. Finally, for adults with grade I-II ankle sprains of variable duration, lower extremity mobilization in addition to home exercise and advice provides greater short-term improvements in activities and function over home exercise and advice alone. No studies were included that evaluated the effectiveness of manual therapy in children or for the management of other extremity injuries in adults. The current evidence on the effectiveness of manual therapy for MSDs of the upper and lower extremities is limited. The available evidence supports the use of manual therapy for non-specific shoulder pain and ankle sprains, but not for subacromial impingement syndrome in adults. Future research is needed to determine the effectiveness of manual therapy and guide clinical practice. CRD42014009899.

Relationship between stress and pain in work-related upper extremity disorders: the hidden role of chronic multisymptom illnesses.

PubMed

Clauw, Daniel J; Williams, David A

2002-05-01

Pain and fatigue are commonly associated with work-related upper extremity disorders. Occasionally these symptoms persist beyond a reasonable healing period. One potential explanation for prolonged symptom expression is the concurrent development of a stress-mediated illness or CMI (Chronic Multi-Symptom Illness). In such a scenario, the chronic regional pain and other symptoms that the individual is experiencing would be attributable to the CMI rather than to tissue damage or a biomechanical dysfunction of the upper-extremity. This article critically reviews the case definitions of the new class of CMI disorders and evaluates the existing evidence supporting centrally mediated physiological changes (e.g., sensory hypervigilance, dysautonomia) that manifest as symptoms of pain and fatigue in some individuals experiencing chronic stressors. While explanations for prolonged pain and fatigue have historically focused on mechanisms involving peripheral pathology or psychiatric explanations, ample evidences support the role of altered Central Nervous System function in accounting for symptom manifestation in CMI. A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.

[Pathogenesis of hypophosphatemia].

PubMed

Takeuchi, Yasuhiro

2016-02-01

Chronic hypophosphatemia is seriously involved in several disorders of musculoskeletal system. Symptoms of patients are usually non-specific, such as pain with or without muscle weakness on lower extremities and are often hard to be correctly diagnosed. It is clinically important for physicians to understand pathogenesis and clinical features of hypophosphatemia and its related diseases.

Prevalence of Symptoms of Depression, Anxiety, and Posttraumatic Stress Disorder in Workers With Upper Extremity Complaints.

PubMed

Degen, Ryan M; MacDermid, Joy C; Grewal, Ruby; Drosdowech, Darren S; Faber, Kenneth J; Athwal, George S

2016-07-01

Study Design Cross-sectional cohort study. Background Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Objectives To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Methods In 2010, 418 patients completed the PHQ during their initial evaluation. Patients with PHQ scores exceeding threshold values for symptoms of depression, PD, or PTSD were compared based on patient-reported outcome scores, including the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The prevalence of symptoms, and their relationship with presenting complaints and patient-reported outcomes, were calculated. Results Thirty-one percent of patients scored above thresholds for symptoms of at least 1 mental health disorder. Of those who screened positive, 67% screened positive for depression, 44% for PTSD, and 50% for PD, with 43% of patients positive for multiple symptoms. Patients experiencing neck pain had significantly higher screening rates of depressive symptoms (62.5% versus 20.1%, P = .004) and PD (37.5% versus 12.9%, P = .044) compared with other presenting complaints. Similarly, patients with chronic pain had higher rates of depression (54.5% versus 20.1%, P = .006), PD (63.6% versus 12%, P<.001), and PTSD (36.4% versus 14.8%, P = .05) compared with other presenting complaints. Patients endorsing depressive symptoms had significantly lower SF-36 mental component summary scores (26.3 ± 10.7 versus 37.6 ± 9.9, P<.001) and higher shortened-version DASH (72.3 ± 16.7 versus 61.5 ± 11.1, P = .003) and DASH work scores (86.5 ± 19.2 versus 82.1 ± 20.1, P = .007) compared to patients endorsing other items on the PHQ. Conclusion In this prospective cohort study of injured workers, we identified a relatively high prevalence of symptoms of psychological disorders utilizing the PHQ, with one third of injured workers screening positive for symptoms of depression, PD, or PTSD. Further longitudinal follow-up is necessary to determine the impact on treatment outcomes. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2016;46(7):590-595. Epub 12 May 2016. doi:10.2519/jospt.2016.6265.

Psychosocial indicators among aircraft maintenance workers with and without neck and shoulder musculoskeletal symptoms.

PubMed

Oliveira, A; Nogueira, H; Diniz, A; Barbieri, D

2012-01-01

In the aircraft maintenance industry, most of workers performs manual handling tasks of different materials, varying from small objects up to large pieces of the aircraft. It can increase the occurrence of work-related musculoskeletal disorders (WMSDs), which are strongly associated with high physical demands required by the task. Moreover, psychosocial demands are considered as risk factors for musculoskeletal disorders in both the upper limbs and lumbar spine. Thus, the objective of this study was to assess psychosocial indicators among aircraft maintenance workers according to the presence of neck and shoulder musculoskeletal symptoms. Eighty workers of an aircraft maintenance company were evaluated (32.69 ± 8.25 years, 79.8 ± 13.4 kg, 175 ± 7 cm). According to physical examination, 50 workers were classified as asymptomatic (AS - 4.1 ± 3.17 positive signs) whilst 30 workers were classified as symptomatic (SS - 26.72 ± 11.44 positive signs). AS and SS have shown similar profile of demand (p = 0.62), control (p = 0.66) and social support (p = 0.74) according to the Job Content Questionnaire. However, the groups are different when considering work engagement variables. In general, SS have higher scores than AS (p < 0.05).

Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use.

PubMed

Silva, Georgia Rodrigues Reis; Pitangui, Ana Carolina Rodarti; Xavier, Michele Katherine Andrade; Correia-Júnior, Marco Aurélio Valois; De Araújo, Rodrigo Cappato

2016-01-01

This study investigated the presence of musculoskeletal symptoms in high school adolescents from public schools and its association with electronic device use. The sample consisted of 961 boys and girls aged 14-19 years who answered a questionnaire regarding the use of computers and electronic games, and questions about pain symptoms and physical activity. Furthermore, anthropometric assessments of all volunteers were performed. The chi-squared test and a multiple logistic regression model were used for the inferential analysis. The presence of musculoskeletal pain symptoms was reported by 65.1% of the adolescents, being more prevalent in the thoracolumbar spine (46.9%), followed by pain in the upper limbs, representing 20% of complaints. The mean time of use for computers and electronic games was 1.720 and 583 minutes per week, respectively. The excessive use of electronic devices was demonstrated to be a risk factor for cervical and lumbar pain. Female gender was associated with the presence of pain in different body parts. Presence of a paid job was associated with cervical pain. A high prevalence of musculoskeletal pain in adolescents, as well as an increased amount of time using digital devices was observed. However, it was only possible to observe an association between the increased use of these devices and the presence of cervical and low back pain. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

A literature review of the effects of computer input device design on biomechanical loading and musculoskeletal outcomes during computer work.

PubMed

Bruno Garza, J L; Young, J G

2015-01-01

Extended use of conventional computer input devices is associated with negative musculoskeletal outcomes. While many alternative designs have been proposed, it is unclear whether these devices reduce biomechanical loading and musculoskeletal outcomes. To review studies describing and evaluating the biomechanical loading and musculoskeletal outcomes associated with conventional and alternative input devices. Included studies evaluated biomechanical loading and/or musculoskeletal outcomes of users' distal or proximal upper extremity regions associated with the operation of alternative input devices (pointing devices, mice, other devices) that could be used in a desktop personal computing environment during typical office work. Some alternative pointing device designs (e.g. rollerbar) were consistently associated with decreased biomechanical loading while other designs had inconsistent results across studies. Most alternative keyboards evaluated in the literature reduce biomechanical loading and musculoskeletal outcomes. Studies of other input devices (e.g. touchscreen and gestural controls) were rare, however, those reported to date indicate that these devices are currently unsuitable as replacements for traditional devices. Alternative input devices that reduce biomechanical loading may make better choices for preventing or alleviating musculoskeletal outcomes during computer use, however, it is unclear whether many existing designs are effective.

Upper extremity paraesthesia: clinical assessment and reasoning.

PubMed

Muscolino, Joseph E

2008-07-01

The art of clinical assessment involves an accurate determination of the cause(s) of a patient's symptoms. Given that a set of symptoms can be influenced by many contributing factors and features, assessment needs to differentially evaluate these. Accurate and appropriate treatment depends on differential assessment based on sound clinical reasoning. Many conditions derive from multiple causes demanding evaluation of as many etiological features as can be identified. The case review presented here involves a patient presenting with paraesthesia spreading into her right upper extremity. A complex history, involving her neck and contralateral upper extremity was assessed. The patient was found to have at least seven underlying, predisposing, and etiological, conditions capable of initiating, aggravating, or maintaining the presenting symptoms. Weighing the relative contributions of these often interacting features, and correlating this with the history, helped to identify a successful course of treatment.

Musculoskeletal symptoms and ergonomic hazards among material handlers in grocery retail industries

NASA Astrophysics Data System (ADS)

Nasrull Abdol Rahman, Mohd; Zuhaidi, Muhammad Fareez Ahmad

2017-08-01

Grocery retail work can be physically demanding as material handler’s tasks involve manual lifting, lowering, carrying, pushing and pulling loads. The nature of this work puts them at a risk for serious low back pain, shoulder pain and other musculoskeletal injuries. This study was conducted by using two different types of tools which were Nordic Musculoskeletal Questionnaire (NMQ) as a survey and Washington Industrial Safety and Health Act (WISHA) Checklist as a direct observation method. Among 46 males and 14 females material handlers were involved throughout this study. For NMQ, the highest body part trouble in the last 12 months was low back pain (88.3%), followed by upper back (68.3%), neck (55.3%) and shoulder (36.7%). While for WISHA Checklist, most of them experienced hazard level involving awkward posture and high hand force. From the research conducted, musculoskeletal disorders (MSDs) and ergonomic risk factors (ERFs) do related as it showed that musculoskeletal disorders may arise if the workers ignored the safety in ergonomic hazards.

Occupational Injuries on Thoroughbred Horse Farms: A Description of Latino and Non-Latino Workers’ Experiences

PubMed Central

Swanberg, Jennifer E.; Clouser, Jessica M.; Westneat, Susan C.; Marsh, Mary W.; Reed, Deborah B.

2013-01-01

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry’s workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed. PMID:24351785

The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

PubMed Central

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

2016-01-01

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground. PMID:27062591

Shoulder model validation and joint contact forces during wheelchair activities.

PubMed

Morrow, Melissa M B; Kaufman, Kenton R; An, Kai-Nan

2010-09-17

Chronic shoulder impingement is a common problem for manual wheelchair users. The loading associated with performing manual wheelchair activities of daily living is substantial and often at a high frequency. Musculoskeletal modeling and optimization techniques can be used to estimate the joint contact forces occurring at the shoulder to assess the soft tissue loading during an activity and to possibly identify activities and strategies that place manual wheelchair users at risk for shoulder injuries. The purpose of this study was to validate an upper extremity musculoskeletal model and apply the model to wheelchair activities for analysis of the estimated joint contact forces. Upper extremity kinematics and handrim wheelchair kinetics were measured over three conditions: level propulsion, ramp propulsion, and a weight relief lift. The experimental data were used as input to a subject-specific musculoskeletal model utilizing optimization to predict joint contact forces of the shoulder during all conditions. The model was validated using a mean absolute error calculation. Model results confirmed that ramp propulsion and weight relief lifts place the shoulder under significantly higher joint contact loading than level propulsion. In addition, they exhibit large superior contact forces that could contribute to impingement. This study highlights the potential impingement risk associated with both the ramp and weight relief lift activities. Level propulsion was shown to have a low relative risk of causing injury, but with consideration of the frequency with which propulsion is performed, this observation is not conclusive.

[Upper extremities, neck and back symptoms in office employees working at computer stations].

PubMed

Zejda, Jan E; Bugajska, Joanna; Kowalska, Małgorzata; Krzych, Lukasz; Mieszkowska, Marzena; Brozek, Grzegorz; Braczkowska, Bogumiła

2009-01-01

To obtain current data on the occurrence ofwork-related symptoms of office computer users in Poland we implemented a questionnaire survey. Its goal was to assess the prevalence and intensity of symptoms of upper extremities, neck and back in office workers who use computers on a regular basis, and to find out if the occurrence of symptoms depends on the duration of computer use and other work-related factors. Office workers in two towns (Warszawa and Katowice), employed in large social services companies, were invited to fill in the Polish version of Nordic Questionnaire. The questions included work history and history of last-week symptoms of pain of hand/wrist, elbow, arm, neck and upper and lower back (occurrence and intensity measured by visual scale). Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences (chi-square test) were verified by multivariate analysis (GLM). The prevalence of symptoms in individual body parts was as follows: neck, 55.6%; arm, 26.9%; elbow, 13.3%; wrist/hand, 29.9%; upper back, 49.6%; and lower back, 50.1%. Multivariate analysis confirmed the effect of gender, age and years of computer use on the occurrence of symptoms. Among other determinants, forearm support explained pain of wrist/hand, wrist support of elbow pain, and chair adjustment of arm pain. Association was also found between low back pain and chair adjustment and keyboard position. The findings revealed frequent occurrence of symptoms of pain in upper extremities and neck in office workers who use computers on a regular basis. Seating position could also contribute to the frequent occurrence of back pain in the examined population.

The influence of wheelchair propulsion technique on upper extremity muscle demand: a simulation study.

PubMed

Rankin, Jeffery W; Kwarciak, Andrew M; Richter, W Mark; Neptune, Richard R

2012-11-01

The majority of manual wheelchair users will experience upper extremity injuries or pain, in part due to the high force requirements, repetitive motion and extreme joint postures associated with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reducing upper extremity demand during propulsion. However, studies often make comparisons between populations (e.g., able-bodied vs. paraplegic) or do not investigate specific measures of upper extremity demand. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to investigate how altering cadence, peak force and contact angle influence individual muscle demand. Forward dynamics simulations of wheelchair propulsion were generated to emulate group-averaged experimental data during four conditions: 1) self-selected propulsion technique, and while 2) minimizing cadence, 3) maximizing contact angle, and 4) minimizing peak force using biofeedback. Simulations were used to determine individual muscle mechanical power and stress as measures of muscle demand. Minimizing peak force and cadence had the lowest muscle power requirements. However, minimizing peak force increased cadence and recovery power, while minimizing cadence increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscle power requirements. Minimizing cadence appears to have the most potential for reducing muscle demand and fatigue, which could decrease upper extremity injuries and pain. However, altering any of these variables to extreme values appears to be less effective; instead small to moderate changes may better reduce overall muscle demand. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Italian translation and validation of the Nordic IRSST standardized questionnaire for the analysis of musculoskeletal symptoms].

PubMed

Gobba, F; Ghersi, R; Martinelli, Simona; Richeldi, Arianna; Clerici, Piera; Grazioli, P

2008-01-01

Data on self-reported symptoms and/or functional impairments are important in research on work-related musculoskeletal disorders (WRMSDs). In such cases the availability of international standardized questionnaires is extremely important since they permit comparison of studies performed in different Countries. Translation into Italian and validation of the Nordic Musculoskeletal Questionnaire (NMQ), a tool which is widely used in studies on WRMSDs in the international scientific literature. The extended Canadian version of the NMQ was translated into Italian. As per the current guidelines, the cross-cultural adaptation was performed by translation of the items from French, back-translation by independent mother-tongue translators and committee review. The resulting version of the questionnaire underwent pre-testing in 3 independent groups of subjects. The comprehensibility, reliability (internal consistency and reproducibility) and sensitivity were evaluated. After translation/back-translation and review of the items the comprehensibility of the Italian version of the questionnaire was judged good in a group of 40 workers. The internal consistency was evaluated using the Cronbach's Alpha test in the same group and in another 98 engineering workers: the results were on the whole acceptable. The reproducibility, which was tested with Cohen's Kappa test in the 40 workers, was good/excellent. In a preliminary evaluation, performed in 30 outpatients of a of Rehabilitation Service, sensitivity was very good. The results show that the Italian version of the Nordic Musculoskeletal Questionnaire is valid for self-administration and can be applied in 'field" studies on self-reported musculoskeletal symptoms and functional impairments in group of workers.

Musculoskeletal disorders among construction workers: a one-year follow-up study

PubMed Central

2012-01-01

Background Work-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time of follow-up. Conclusions A substantial number of the bricklayers and the supervisors report musculoskeletal disorders, mainly back, knee and shoulder/upper arm complaints. The majority of the bricklayers and half of the supervisors believe that their complaints are work-related. Irrespective of occupation, participants with MSDs report substantial problems during work. Workplace intervention measures aimed at occupational physical tasks and activities seem justified for both occupations. PMID:23061990

Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses.

PubMed

Cromie, J E; Robertson, V J; Best, M O

2000-04-01

Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Little is known of how therapists respond or of what actions they take to prevent injury. The purpose of this study was to investigate the prevalence and severity of WMSDs in physical therapists, contributing risk factors, and their responses to injury. As part of a larger study, a systematic sample of 1 in 4 therapists on a state register (n=824) was surveyed. An 8-page questionnaire was mailed to each subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-related risk factors, injury prevention strategies, and responses to injury. Lifetime prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the profession as a result of WMSDs. Younger therapists reported a higher prevalence of WMSDs in most body areas. Use of mobilization and manipulation techniques was related to increased prevalence of thumb symptoms. Risk factors pertaining to workload were related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors were related to a higher prevalence of spinal symptoms. Strategies used to reduce work-related injury in industry may also apply to physical therapists. Increased risk of thumb symptoms associated with mobilization techniques suggests that further research is needed to establish recommendations for practice. The issues for therapists who move within or leave the profession are unknown, and further research is needed to better understand their needs and experiences.

Postural loading assessment in assembly workers of an Iranian telecommunication manufacturing company.

PubMed

Kamalinia, Mojtaba; Nasl Saraji, Gebreal; Kee, Dohyung; Hosseini, Mostafa; Choobineh, Alireza

2013-01-01

Changes in industries and work practices have coincided with work-related musculoskeletal disorders (MSDs). This study was conducted to determine the prevalence of MSDs and to assess postural loading in assembly workers of an Iranian telecommunication manufacturing company. Data were collected from 193 randomly selected workers in 4 units of the company. The Nordic musculoskeletal disorders questionnaire and the UBC ergonomic checklist were used as data collection tools. Loading on the upper body assessment (LUBA) was used to assess postural loading. Lower back symptoms were the most prevalent problems among the workers (67.9%). LUBA showed that most assembly workers (94.3%) had experienced considerable and high postural loading (postural load index, PLI > 5). Regression analyses revealed that lighting, rotation, contact stress, repetition, gender and age were factors associated with symptoms. Work-related MSDs occurred at a high rate among workers. Postural loading requires consideration. Any ergonomic intervention should focus on eliminating ergonomic factors associated with symptoms.

Musculoskeletal pain among Polish music school students.

PubMed

Nawrocka, Agnieszka; Mynarski, Władysław; Powerska-Didkowska, Aneta; Grabara, Małgorzata; Garbaciak, Wiesław

2014-06-01

To assess the prevalence and intensity of musculoskeletal pain and to estimate probability of developing playing-related musculoskeletal disorders, depending on risk factors, including gender, years of playing the musical instrument, frequency of practice (number of days per week), average daily practice time, and habitual physical activity level, in young instrumentalists. A total of 225 instrumentalists aged 10-18 years, including 107 string-players, 64 keyboardists, and 54 wind-players, were investigated. The Nordic Musculoskeletal Questionnaire (NMQ) together with a numerical visual-analogue pain intensity scale (VAS) was used to assess the participants' musculoskeletal pain. The young instrumentalists most often complained of pain located in the neck (60.4%), wrists (44.4%), and upper (41.7%) and lower back (38.2%) areas. Girls complained of musculoskeletal pain significantly more often than the boys. A probability of the pain symptoms was increased with each consecutive year of practice (OR 1.135; 95%CI 1.021-1.261). Musculoskeletal pain in various body parts had already commenced at a young age in our sample of music students, and there was a gender difference (girls were more often affected). Results of our study suggest that an early prophylaxis of playing-related musculoskeletal disorders is needed among young musicians playing the various instruments.

Prevalence of Work-related Musculoskeletal Symptoms among Iranian Workforce and Job Groups.

PubMed

Choobineh, Alireza; Daneshmandi, Hadi; Saraj Zadeh Fard, Seyed Kazem; Tabatabaee, Seyed Hamidreza

2016-01-01

Musculoskeletal disorders (MSDs) are known to cause occupational injuries. This study aimed to collate the existed relevant data and develop a general feature of MSDs problem among Iranian workforce. In this study, we used the raw data related to 8004 employees from 20 Iranian industrial settings distributed throughout the country. In all studies, participants were selected based on simple random sampling method, and the data were collected using demographic characteristics and Nordic MSDs questionnaires. The most prevalent MSDs symptoms were reported in the lower back (48.9%), shoulders (45.9%), neck (44.2%), upper back (43.8%), and knees (43.8%). Prevalence rates of MSDs at least in one body region were found to be the highest (90.3%) among health-care workers. Prevalence rates of MSDs symptoms in all body regions were higher among workers with dynamic activities as compared to those of workers with static activities. MSDs symptoms were common among the study population. Health-care provider and workers with dynamic activities had the highest rate of MSDs. These results merit attention in planning and implementing ergonomics interventional program in Iranian industrial settings.

Mechanistic experimental pain assessment in computer users with and without chronic musculoskeletal pain.

PubMed

Ge, Hong-You; Vangsgaard, Steffen; Omland, Øyvind; Madeleine, Pascal; Arendt-Nielsen, Lars

2014-12-06

Musculoskeletal pain from the upper extremity and shoulder region is commonly reported by computer users. However, the functional status of central pain mechanisms, i.e., central sensitization and conditioned pain modulation (CPM), has not been investigated in this population. The aim was to evaluate sensitization and CPM in computer users with and without chronic musculoskeletal pain. Pressure pain threshold (PPT) mapping in the neck-shoulder (15 points) and the elbow (12 points) was assessed together with PPT measurement at mid-point in the tibialis anterior (TA) muscle among 47 computer users with chronic pain in the upper extremity and/or neck-shoulder pain (pain group) and 17 pain-free computer users (control group). Induced pain intensities and profiles over time were recorded using a 0-10 cm electronic visual analogue scale (VAS) in response to different levels of pressure stimuli on the forearm with a new technique of dynamic pressure algometry. The efficiency of CPM was assessed using cuff-induced pain as conditioning pain stimulus and PPT at TA as test stimulus. The demographics, job seniority and number of working hours/week using a computer were similar between groups. The PPTs measured at all 15 points in the neck-shoulder region were not significantly different between groups. There were no significant differences between groups neither in PPTs nor pain intensity induced by dynamic pressure algometry. No significant difference in PPT was observed in TA between groups. During CPM, a significant increase in PPT at TA was observed in both groups (P < 0.05) without significant differences between groups. For the chronic pain group, higher clinical pain intensity, lower PPT values from the neck-shoulder and higher pain intensity evoked by the roller were all correlated with less efficient descending pain modulation (P < 0.05). This suggests that the excitability of the central pain system is normal in a large group of computer users with low pain intensity chronic upper extremity and/or neck-shoulder pain and that increased excitability of the pain system cannot explain the reported pain. However, computer users with higher pain intensity and lower PPTs were found to have decreased efficiency in descending pain modulation.

Psychological and physical correlates of musculoskeletal symptoms in male professional divers and offshore workers

PubMed Central

2013-01-01

Background Underwater divers are more likely to complain of musculoskeletal symptoms than a control population. Accordingly, we conducted a study to determine whether musculoskeletal symptoms reflected observable physical disorder, to ascertain the relationship between symptoms and measures of mood, memory and executive function and to assess any need for future screening. Methods A 10% random sample of responders to a prior postal health questionnaire was examined (151 divers, 120 non-diving offshore workers). Participants underwent physical examination and a neuropsychological test battery for memory and executive function. Participants also completed the Hospital Anxiety and Depression Scale for anxiety (HADSa) and depression (HADSd), and questionnaires for physical health-related quality of life (SF36 PCS), mental health-related quality of life (SF36 MCS), memory (Cognitive Failures Questionnaire (CFQ), Prospective and Retrospective Memory Questionnaire (PRMQ)), executive function (dysexecutive syndrome questionnaire (DEX)), musculoskeletal symptoms (MSS) and general unrelated symptom reporting. Results Of participants with moderate/severe musculoskeletal symptoms, 52% had physical signs, and of participants with no symptoms, 73% had no physical signs. There was no difference in the prevalence of signs or symptoms between groups. Musculoskeletal symptoms were associated with lower SF36 PCS for both groups. In divers, musculoskeletal symptoms were associated with higher general unrelated symptom reporting and poorer scoring for HADSa, PRMQ, CFQ and DEX with scores remaining within the normative range. A positive physical examination was associated with general unrelated symptom reporting in divers. There were no differences in neuropsychological test scores attributable to either group or musculoskeletal symptoms. Conclusions Musculoskeletal symptoms were associated with physical signs, but this was not a strong effect. Reporting of musculoskeletal symptoms by the divers studied was also associated with a tendency to report symptoms generally or somatisation, and caution should be exercised regarding their interpretation as an indication of physical disease or their use for health screening. PMID:23849557

The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies.

PubMed

Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory

2016-05-03

(1) BACKGROUND: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) OBJECTIVE: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) MATERIAL AND METHODS: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) RESULTS: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) CONCLUSIONS: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment.

The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies

PubMed Central

Chanchai, Withaya; Songkham, Wanpen; Ketsomporn, Pranom; Sappakitchanchai, Punnarat; Siriwong, Wattasit; Robson, Mark Gregory

2016-01-01

(1) Background: Musculoskeletal disorders have a multifactorial etiology that is not only associated with physical risk factors, but also psychosocial risk factors; (2) Objective: This study evaluated the effects of an ergonomic intervention on musculoskeletal disorders and psychosocial risk factors; (3) Material and Methods: This study took a participatory ergonomic (PE) approach with a randomized controlled trial (RCT) conducted at tertiary care hospitals during July to December 2014. A group of hospital orderlies in Thailand were randomly selected for examination. Fifty orderlies were placed in a case group and another 50 orderlies were placed in the control group. The Nordic Musculoskeletal Disorders Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for data collection before and after the intervention program; (4) Results: The most commonly reported problem among hospital orderlies was found to be lower back symptoms (82%). The study found significant differences in prevalence rates of reported musculoskeletal conditions in the arm, upper back, and lower back regions before and after intervention. Findings showed that psychosocial risk factors were affected by the intervention. COPSOQ psychosocial risk factors were significantly different pre/post intervention. These variables included: work pace, influence at work, meaning of work, predictability, rewards, role conflicts, and social support from supervisors. No other psychosocial risk factors were found to be significant; (5) Conclusions: Positive results were observed following the intervention in the work environment, particularly in terms of reducing physical work environment risk factors for musculoskeletal disorders and increasing promotion factors of the psychosocial work environment. PMID:27153076

[Factors Influencing Musculoskeletal Symptoms in Military Personnel during Basic Combat Training].

PubMed

Yi, Jeong Min; Kim, Gwang Suk

2016-08-01

This study was done to examine physical, psycho-social, and individual factors influencing musculoskeletal symptoms among Korean military trainees. Using a correlation study design, military trainees who had completed almost of all the basic combat training (BCT) days were recruited from two military training units selected by convenience sampling. Data from 415 participants were analyzed. Prevalence of musculoskeletal symptoms was 29.6% defined as a participant having pain or discomfort in one or more body parts during training hours for more than seven consecutive days. Back/pelvic (10.8%), knees (10.1%), shoulders (7.7%), feet/toes (5.6%), ankles (4.8%) were prone to musculoskeletal symptoms. Musculoskeletal symptoms appeared to be related to physical exertion during BCT, stress during BCT, social support from fellow trainees, or previous musculoskeletal injuries. In the logistic regression model, physical exertion during BCT (OR=2.27, 95% CI: 1.42~3.65), stress during BCT (OR=1.79, 95% CI: 1.15~2.78), and previous musculoskeletal injuries (OR=1.58, 95% CI: 1.01~2.47) were the significant factors affecting prevalence of musculoskeletal symptoms. Findings indicate that physical exertion and psycho-social stress should be managed to prevent musculoskeletal symptoms in military trainees with more attention being given to trainees having a history of musculoskeletal injuries.

Emotion regulation strategies mediate the associations of positive and negative affect to upper extremity physical function.

PubMed

Talaei-Khoei, Mojtaba; Nemati-Rezvani, Hora; Fischerauer, Stefan F; Ring, David; Chen, Neal; Vranceanu, Ana-Maria

2017-05-01

The Gross process model of emotion regulation holds that emotion-eliciting situations (e.g. musculoskeletal illness) can be strategically regulated to determine the final emotional and behavioral response. Also, there is some evidence that innate emotional traits may predispose an individual to a particular regulating coping style. We enrolled 107 patients with upper extremity musculoskeletal illness in this cross-sectional study. They completed self-report measures of positive and negative affect, emotion regulation strategies (cognitive reappraisal and expressive suppression), upper extremity physical function, pain intensity, and demographics. We used Preacher and Hayes' bootstrapping approach to process analysis to infer the direct effect of positive and negative affect on physical function as well as their indirect effects through activation of emotion regulation strategies. Negative affect was associated with decreased physical function. The association was partly mediated by expressive suppression (b (SE)=-.10 (.05), 95% BCa CI [-.21, -.02]). Positive affect was associated with increased physical function. Cognitive reappraisal partially mediated this association (b (SE)=.11 (.05), 95% BCa CI [.03, .24]). After controlling for pain intensity, the ratio of the mediated effect to total effect grew even larger in controlled model comparing to uncontrolled model (33% vs. 26% for expressive suppression and 32% vs. 30% for cognitive reappraisal). The relationships between affect, emotion regulation strategies and physical function appear to be more dependent on the emotional response to an orthopedic condition rather than the intensity of the nociceptive stimulation of the pain. Findings support integration of emotion regulation training in skill-based psychotherapy in this population to mitigate the effect of negative affect and enhance the influence of positive affect on physical function. Copyright © 2017 Elsevier Inc. All rights reserved.

Differences in ergonomic and workstation factors between computer office workers with and without reported musculoskeletal pain.

PubMed

Rodrigues, Mirela Sant'Ana; Leite, Raquel Descie Veraldi; Lelis, Cheila Maira; Chaves, Thaís Cristina

2017-01-01

Some studies have suggested a causal relationship between computer work and the development of musculoskeletal disorders. However, studies considering the use of specific tools to assess workplace ergonomics and psychosocial factors in computer office workers with and without reported musculoskeletal pain are scarce. The aim of this study was to compare the ergonomic, physical, and psychosocial factors in computer office workers with and without reported musculoskeletal pain (MSP). Thirty-five computer office workers (aged 18-55 years) participated in the study. The following evaluations were completed: Rapid Upper Limb Assessment (RULA), Rapid Office Strain Assessment (ROSA), and Maastricht Upper Extremity Questionnaire revised Brazilian Portuguese version (MUEQ-Br revised). Student t-tests were used to make comparisons between groups. The computer office workers were divided into two groups: workers with reported MSP (WMSP, n = 17) and workers without positive report (WOMSP, n = 18). Those in the WMSP group showed significantly greater mean values in the total ROSA score (WMSP: 6.71 [CI95% :6.20-7.21] and WOMSP: 5.88 [CI95% :5.37-6.39], p = 0.01). The WMSP group also showed higher scores in the chair section of the ROSA, workstation of MUEQ-Br revised, and in the upper limb RULA score. The chair height and armrest sections from ROSA showed the higher mean values in workers WMSP compared to workers WOMSP. A positive moderate correlation was observed between ROSA and RULA total scores (R = 0.63, p < 0.001). Our results demonstrated that computer office workers who reported MSP had worse ergonomics indexes for chair workstation and worse physical risk related to upper limb (RULA upper limb section) than workers without pain. However, there were no observed differences in workers with and without MSP regarding work-related psychosocial factors. The results suggest that inadequate workstation conditions, specifically the chair height, arm and back rest, are linked to improper upper limb postures and that these factors are contributing to MSP in computer office workers.

Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study.

PubMed

Nwaru, Chioma A; Nygård, Clas-Håkan; Virtanen, Pekka

2016-07-08

Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed.

WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP): Factor Analysis and Internal Consistency.

PubMed

Aerts, Bas R; Kuijer, P Paul; Beumer, Annechien; Eygendaal, Denise; Frings-Dresen, Monique H

2018-04-17

To test a 17-item questionnaire, the WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP), for dimensionality of the items (factor analysis) and internal consistency. Cross-sectional study. Outpatient clinic. A consecutive sample of patients (N=150) consisting of all new referral patients (either from a general physician or other hospital) who visited the orthopedic outpatient clinic because of an upper extremity musculoskeletal disorder. Not applicable. Number and dimensionality of the factors in the WORQ-UP. Four factors with eigenvalues (EVs) >1.0 were found. The factors were named exertion, dexterity, tools & equipment, and mobility. The EVs of the factors were, respectively, 5.78, 2.38, 1.81, and 1.24. The factors together explained 65.9% of the variance. The Cronbach alpha values for these factors were, respectively, .88, .74, .87, and .66. The 17 items of the WORQ-UP resemble 4 factors-exertion, dexterity, tools & equipment, and mobility-with a good internal consistency. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of a noninvasive expandable prosthesis in musculoskeletal oncology patients for the upper and lower limb.

PubMed

Beebe, Kathleen; Benevenia, Joseph; Kaushal, Neil; Uglialoro, Anthony; Patel, Neeraj; Patterson, Francis

2010-06-09

The noninvasive expandable prosthesis is used for limb-salvage surgery following tumor resection in skeletally immature patients. The purpose of this retrospective study is to report our experience with the Repiphysis (Wright Medical Technology, Inc; Arlington, Tennessee) noninvasive expandable prosthesis for both the lower extremity and compassionate use in the upper extremity in 12 patients between 2003 and 2008. Twelve prostheses were implanted in 12 patients with an average follow-up of 38 months (range, 12-78 months). Nine patients underwent a total of 38 expansion procedures. Mean total expansion was 4.5 cm (range, 0.8-9.9 cm). No complications of lengthening occurred. Seven nononcologic complications were noted. One infection was reported in 12 patients. The mean MSTS score after rehabilitation was 24.5 (range, 13-30). The Repiphysis noninvasive prosthesis provides acceptable functional outcomes for both upper and lower extremity implantation and appears to have an advantage as compared to conventional expandable prosthetics, which require open procedures that can potentially increase the risk of infection from repeated hardware exposure. Copyright 2010, SLACK Incorporated.

Prevalence of Work-related Musculoskeletal Symptoms and Their Associations with Job Stress in Female Caregivers Living in South Korea.

PubMed

Roh, Hyolyun; Lee, Daehee; Kim, Yongjae

2014-05-01

[Purpose] The purpose of this study was to assess the work-related musculoskeletal system symptoms and the extent of job stress in female caregivers, as well as the interrelationship between these factors. [Subjects and Methods] Korea Occupational Safety and Health Agency (KOSHA) Code H-43 of the Guidelines for the Examination of Elements Harmful to the Musculoskeletal System was used as a tool to measure musculoskeletal symptoms. Caregiver job stress was assessed from the Korean Occupational Stress Scale short form. [Results] The level of symptoms in the hand/wrist/finger and leg/foot regions had some relation to job stress. Job stress scores were mainly shown to be high when pain was reported. On the other hand, it was shown that the degree of musculoskeletal symptoms by body part was unrelated to conflicts in relationships, job instability, or workplace culture. [Conclusion] As for the correlations between musculoskeletal symptoms and job stress, it was shown that as job requirements increased, most musculoskeletal symptoms also increased.

RELATIONSHIP OF PRESEASON MOVEMENT SCREENS WITH OVERUSE SYMPTOMS IN COLLEGIATE BASEBALL PLAYERS

PubMed Central

Clifton, Daniel R.; Onate, James A.; Ramsey, Vincent K.; Cromartie, Fred

2017-01-01

Background: The shoulder mobility screen of the Functional Movement Screen™ (FMS™) and the upper extremity patterns of the Selective Functional Movement Assessment (SFMA) assess global, multi-joint movement capabilities in the upper-extremities. Identifying which assessment can most accurately determine if baseball players are at an increased risk of experiencing overuse symptoms in the shoulder or elbow throughout a competitive season may reduce throwing-related injuries requiring medical attention. Purpose: The purpose of this study was to determine if preseason FMS™ or SFMA scores were related to overuse severity scores in the shoulder or elbow during the preseason and competitive season. Study design: Cohort study. Methods: Sixty healthy, male, Division III collegiate baseball players (mean age = 20.1 ± 2.0 years) underwent preseason testing using the FMS™ shoulder mobility screen, and SFMA upper extremity patterns. Their scores were dichotomized into good and bad movement scores, and were compared to weekly questionnaires registering overuse symptoms and pain severity in the shoulder or elbow during the season. Results: Poor FMS™ performance was associated with an increased likelihood of experiencing at least one overuse symptom during the preseason independent of grade and position (adjusted odds ratio [OR] = 5.14, p = 0.03). Poor SFMA performance was associated with an increased likelihood of experiencing at least one overuse symptom during the preseason (adjusted OR = 6.10, p = 0.03) and during the competitive season (adjusted OR = 17.07, p = 0.03) independent of grade and position. Conclusion: FMS™ shoulder mobility and SFMA upper extremity pattern performance were related to the likelihood of experiencing overuse symptoms during a baseball season. Participants with poor FMSTM performances may be more likely to experience at least one overuse symptom in their shoulder or elbow during the preseason. Additionally, individuals with poor SFMA performances may be more likely to report overuse symptoms during the preseason or competitive season. Level of evidence: Level 3 PMID:29158957

[The actual condition of musculoskeletal disorders of workers working at new special nursing homes for the aged in Osaka Prefecture--comparison of musculoskeletal disorder between manager's awareness and care workers' complaints by questionnaire survey].

PubMed

Tomioka, Kimiko; Matsunaga, Ichiro

2007-09-01

In order to examine the actual condition of health problems of workers working at new special nursing homes for the aged, we conducted an interview survey with the managers and a questionnaire survey among the workers. Subjects of the interview survey were managers at the 7 nursing homes. Subjects of the questionnaire survey were 362 workers employed at the 7 nursing homes, 214 care workers (CWs) and 104 workers other than care workers (non-CWs); 299 questionnaires were returned. The response rate was 82.6%. We asked the managers "How many CWs are complaining of low back pain (LBP) and upper extremity pain at your nursing home?" One manager answered that 80% of CWs were complaining of LBP, but other managers answered that a few but no more than 5 CWs were complaining of LBP. On the other hand, the prevalence of LBP among CWs by the questionnaire survey was high. The point prevalence of LBP was 70.0%, the one month prevalence of LBP was 81.6%, and the period prevalence of LBP in present job was 88.6%. The managers had less interest in upper extremity pain than in LBP. But more than 60% of CWs had complained of upper extremity pain in the previous 1 month. Seventy-three percent of CWs had not received any education about work-related musculoskeletal disorders although about half of them had got some education or training to minimize the risk of injury in training school. Regarding female workers (77% of all CWs, 73% of all non-CWs), the percentages of current smokers and night shift workers were higher in CWs than in non-CWs with statistically significant differences. The percentages of workers working without work breaks and working overtime were higher in non-CWs than in CWs with statistically significant differences. For prevalence of LBP among female CWs and female non-CWs, the workers having LBP now, having had LBP in present job, and having first experienced LBP in present job were higher in CWs than in non-CWs with statistically significant differences. All nursing homes surveyed had provided no special health examination for LBP. For managers to grasp the actual condition of musculoskeletal disorders of workers working at the nursing homes for the aged, we recommend that care workers should have a special health examination for LBP.

Randomized, Blinded Trial of Vitamin D3 for Treating Aromatase Inhibitor-Associated Musculoskeletal Symptoms (AIMSS)

PubMed Central

Shapiro, Alice C.; Adlis, Susan A.; Robien, Kim; Kirstein, Mark N.; Liang, Shuang; Richter, Sara A.; Lerner, Rachel E.

2017-01-01

Purpose To evaluate the efficacy and safety of vitamin D3 at 4,000 IU/day as a treatment option for aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) when compared with the usual care dose of 600 IU D3. Methods Single site randomized, double-blind, phase 3 clinical trial in women with AIMSS comparing change in symptoms, reproductive hormones and AI pharmacokinetics. Postmenopausal women ≥18 years with stage I-IIIA breast cancer, taking AI and experiencing AIMSS (Breast Cancer Prevention Trial Symptom Scale-Musculoskeletal Subscale ≥1.5 (BCPT-MS)) were admitted. Following randomization, 116 patients had a run-in period of 1 month on 600 IU D3, then began the randomized assignment to either 600 IU D3 (n=56) or 4,000 IU D3 (n=57) daily for 6 months. The primary endpoint was change in AIMSS from baseline (after 1 month run-in) on the BCPT-MS (general musculoskeletal pain; joint pain; muscle stiffness; range for each question: 0=not at all to 4=extremely). Results Groups had no statistically significant differences demographically or clinically. There were no discernable differences between the randomly allocated treatment groups at 6 months in measures of AIMSS, pharmacokinetics of anastrozole and letrozole, serum levels of reproductive hormones, or adverse events. Conclusions We found no significant changes in AIMSS measures between women who took 4000 IU D3 daily compared with 600 IU D3. The 4000 IU D3 did not adversely affect reproductive hormone levels or the steady state pharmacokinetics of anastrozole or letrozole. In both groups, serum 25(OH)D remained in the recommended range for bone health (≥30 ng/mL) and safety (<50 ng/mL). PMID:26868123

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.

PubMed

Bot, Sandra D M; Terwee, Caroline B; van der Windt, Daniëlle A W M; van der Beek, Allard J; Bouter, Lex M; Dekker, Joost

2007-08-01

To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.

Modifications in Wheelchair Propulsion Technique with Speed.

PubMed

Russell, Ian M; Raina, Shashank; Requejo, Philip S; Wilcox, Rand R; Mulroy, Sara; McNitt-Gray, Jill L

2015-01-01

Repetitive loading of the upper limb joints during manual wheelchair (WC) propulsion (WCP) has been identified as a factor that contributes to shoulder pain, leading to loss of independence and decreased quality of life. The purpose of this study was to determine how individual manual WC users with paraplegia modify propulsion mechanics to accommodate expected increases in reaction forces (RFs) generated at the pushrim with self-selected increases in WCP speed. Upper extremity kinematics and pushrim RFs were measured for 40 experienced manual WC users with paraplegia while propelling on a stationary ergometer at self-selected free and fast propulsion speeds. Upper extremity kinematics and kinetics were compared within subject between propulsion speeds. Between group and within-subject differences were determined (α = 0.05). Increased propulsion speed was accompanied by increases in RF magnitude (22 of 40, >10 N) and shoulder net joint moment (NJM, 15 of 40, >10 Nm) and decreases in pushrim contact duration. Within-subject comparison indicated that 27% of participants modified their WCP mechanics with increases in speed by regulating RF orientation relative to the upper extremity segments. Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds. Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.

[Analysis of musculoskeletal disorders, work load and working postures among manufacturing workers].

PubMed

Yu, Shan-fa; Gu, Gui-zhen; Sun, Shi-yi; Wang, Hai-sheng; Cui, Shou-ming; Yang, Xiao-fa; Yang, Shu-le; He, Li-hua; Wang, Sheng

2011-03-01

To analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers. In a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires. The morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period. There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P < 0.05 or P < 0.01). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels (P < 0.05 or P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P < 0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher; but those in garments and diamond factories were lower. The morbidities for musculoskeletal symptoms in waist, neck, shoulder and wrists of workers in manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.

Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention: a worksite RCT among cleaners.

PubMed

Korshøj, Mette; Birk Jørgensen, Marie; Lidegaard, Mark; Mortensen, Ole Steen; Krustrup, Peter; Holtermann, Andreas; Søgaard, Karen

2017-07-01

Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. The objective was to investigate if aerobic exercise affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. One-hundred-and-sixteen cleaners aged 18-65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures in health promotion. Strata were formed according to closest manager (total 11 strata); clusters were set within strata (total 40 clusters, 20 in each group). Musculoskeletal pain data from eight body regions was collected at baseline and after 4- and 12-months follow-up. The participants stated highest pain in the last month on a scale from 0, stating no pain, up to 10, stating worst possible pain. A repeated-measure 2 × 2 multi-adjusted mixed-models design was applied to compare the between-groups differences in an intention to treat analysis. Participants were entered as a random effect nested in clusters to account for the cluster-based randomization. Clinically significant reductions (>30%, f  2 > 0.25) in the aerobic exercise group, compared to the reference group, in pain intensity in neck, shoulders, arms/wrists were found at 12-months follow-up, and a tendency ( p = 0.07, f  2 = 0.18) to an increase for the knees. At 4-months follow-up the only significant between-group change was an increase in hip pain. This study indicates that aerobic exercise reduces musculoskeletal pain in the upper extremities, but as an unintended side effect may increase pain in the lower extremities. Aerobic exercise interventions among workers standing or walking in the majority of the working hours should tailor exercise to only maintain the positive effect on musculoskeletal pain.

Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice.

PubMed

Sostres, Carlos; Carrera-Lasfuentes, Patrica; Lanas, Angel

2017-10-01

The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (<30 days) of NSAIDs including high-dose acetylsalicylic acid (ASA). NSAID use was associated with increased risk of upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that current prevention strategies may not reach a wide population of short-term NSAID users.

Profiles of musculoskeletal development in limbs of college Olympic weightlifters and wrestlers.

PubMed

Kanehisa, H; Fukunaga, T

1999-04-01

To investigate the event-related profiles of musculoskeletal development in weight-categorized athletes, we measured the cross-sectional areas (CSA) of bone and muscle in the forearm, upper arm, lower leg and thigh, using a B-mode ultrasound apparatus, in college Olympic weightlifters (OWL, n = 19) and wrestlers (WR, n = 17) and untrained men (UM, n = 24), whose body masses were within the range from 55 kg to 78 kg. Both bone and muscle CSA at all sites were significantly correlated to the two-thirds power of fat-free mass (FFM(2/3)) with correlation coefficients of 0.430-40.741 (P < 0.05) and 0.608-0.718 (P < 0.05), respectively. Moreover, there were significant correlations between bone and muscle CSA at all sites (r = 0.664-0.829, P < 0.05). Even when bone and muscle CSA were expressed relative value to FFM(2/3), both OWL and WR showed significantly greater values than UM at all sites except for the lower leg. Furthermore, the comparison of the lean (bone + muscle) CSA ratio from site to site indicated a higher distribution of lean tissues in the upper extremities in OWL and WR compared to UM. While there was no significant difference between the two athlete groups in FFM(2/3), OWL showed significantly larger values than WR in the bone CSA of the upper arm and thigh and in the muscle CSA of the lower leg and thigh. However, lean CSA ratios of the upper extremities to the lower ones were significantly higher in WR than in OWL. Thus, the present results indicated that, compared to UM, OWL and WR had a greater lean tissue CSA in limbs, especially in the upper extremities, even when the difference in FFM was normalized. Moreover, the relative distribution of lean tissues in limbs differed between the two weight-categorized athletes in spite of there being no difference in FFM, which may be attributable to their own training regimens and/or competition style.

Musculoskeletal manifestations of Fabry disease: A retrospective study.

PubMed

Lidove, Olivier; Zeller, Valérie; Chicheportiche, Valérie; Meyssonnier, Vanina; Sené, Thomas; Godot, Sophie; Ziza, Jean-Marc

2016-07-01

Fabry disease is a rare X-linked metabolic disorder characterized by a deficiency in the enzyme alpha-galactosidase A. Both males and females can be affected. The main presenting symptom is pain in the extremities, whereas at a more advanced stage, the manifestations include hypertrophic cardiomyopathy, cardiac dysrhythmia, proteinuria, chronic kidney dysfunction, stroke, and hearing loss. When not diagnosed and treated, Fabry disease causes early death. No studies specifically designed to describe the musculoskeletal manifestations of Fabry disease are available. We conducted a single-center retrospective study of patients receiving follow-up at a Fabry disease referral center. We described the musculoskeletal manifestations and analyzed the differential diagnoses. Our study included 40 patients belonging to 20 families, including 25 females with a mean age of 44.2 years (range, 20-76 years) and 15 males with a mean age of 40.1 years (range, 16-61 years). Mean age at the diagnosis of Fabry disease was 37.2 years (range, 7-71 years) in the females and 26.9 years (range, 9-51 years) in the males. Specific enzyme replacement therapy was given to 10 (40%) females and 12 (80%) males. Musculoskeletal manifestations were as follows: past or present pain in the extremities (13 females and 10 males), combined in some patients with vasomotor disorders in the extremities and telangiectasia; exercise intolerance (12 females and 12 males); osteoporotic fractures (2 brothers aged 45 and 44 years, respectively); osteoporosis (3 females, aged 57, 63, and 75 years, respectively), which contributed to death in the oldest patient; osteopenia (2 females aged 38 and 47 years, respectively; and 1 male aged 43 years); Charcot foot and lymphedema with serious infectious complications (4 males older than 40 years), with avascular osteonecrosis of the lower limbs in 2 cases; toe amputations (3 cases); bilateral lower-limb amputation (1 case); abnormally slender lower limbs (5 females and 8 males); acute gout (3 males with severe chronic kidney failure); and carpal tunnel syndrome (1 female and 1 male, both younger than 40 years). Mistaken diagnoses that were made at an early stage, contributing to delay the identification of Fabry disease, included rheumatic fever (2 females and 2 males), growing pains (2 males), pain with paralysis (1 female), chilblains of the lower limbs (1 female), and erythermalgia (1 female). In adulthood, the following mistaken diagnoses were made: Sjögren's syndrome and/or sicca syndrome (6 females), systemic sclerosis (1 male), dysautonomia (1 female), and familial Mediterranean fever (1 female). The diagnosis of Fabry disease is usually delayed, due to confusion with more common disorders. Musculoskeletal manifestations may constitute the presenting symptoms. Past or present pain in the extremities is typical. Osteoporosis may develop early and become severe. Together with the family history, the presence of musculoskeletal manifestations can lead to the correct diagnosis by prompting alpha-galactosidase assays in males and genetic testing in females. Fabry disease is often responsible for musculoskeletal manifestations, of which the most common are pain in the extremities and osteoporosis. These manifestations can be inaugural and lead to diagnostic wanderings. They require specific treatment strategies. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Early retirement among Danish female cleaners and shop assistants according to work environment characteristics and upper extremity complaints: an 11-year follow-up study.

PubMed

Jensen, Lone Donbæk; Bonde, Jens Peter Ellekilde; Christensen, Michael Victor; Maribo, Thomas

2016-05-04

Studies have shown a negative social gradient in the incidence of early retirement. To prevent undesired early retirement, there is a need for knowledge of specific predictors in addition to social factors with a limited potential for change. The main purpose of this study was to examine musculoskeletal complaints and working conditions as predictors of early retirement among Danish female cleaners. Using Cox regression with an adjustment for extraneous factors, we compared the risk of disability pension and retirement before the nominal retirement age (65 years) in an 11-year cohort study with registry-based follow-up of 1430 female cleaners and 579 shop assistants. In subsequent analyses of female cleaners, disability pension and voluntary early retirement were modeled according to work characteristics and upper extremity complaints. The adjusted hazard rate (HR) for disability pension among cleaners compared to the control group was 2.27 (95% CI 1.58 to 3.28) and, for voluntary early retirement, 1.01 (95% CI 0.85 to 1.20). In the subset of cleaners, the predictors of disability pension were persistent shoulder pain HR: 1.98 (95% CI 1.47 to 2.67), elbow pain HR: 1.41 (95% CI 1.02 to 1.94) and symptoms of nerve entrapment of the hand HR: 1.58 (95% CI 1.14 to 2.20). Predictors of voluntary early retirement were persistent shoulder pain HR: 1.40 (95% CI 1.16 to 1.67) and floor mopping for more than 10 h per week HR: 1.20 (95% CI 1.03 to 1.40). Cleaners have a twofold higher risk of disability pension compared to the control group. Risk factors for disability pension among cleaners were persistent shoulder and elbow pain together with symptoms of nerve entrapment of the hand. The findings of specific health related predictors of early retirement could be used in secondary prevention with targeted temporary reduced workload.

Musculoskeletal injuries in auto racing: a retrospective study of 137 drivers.

PubMed

Koutras, Christos; Buecking, Benjamin; Jaeger, Marcus; Ruchholtz, Steffen; Heep, Hansjoerg

2014-11-01

The effect of continuous exposure of a driver's bones and muscles to vibration and G forces to years of automobile racing and the effect on overall health have not yet been examined in detail. The goal of this study was to investigate via questionnaire the musculoskeletal injuries and influencing parameters in 130 amateur and 7 professional race car drivers. A questionnaire, translated in English and German, was used to investigate the parameters that influence the racing performance and the character of resulting injuries. This investigation involved 137 drivers (133 men and 4 women) with a mean age of 42 years (standard deviation = 15). Approximately half of the drivers had < 10 years of experience in auto racing (49%). The drivers mainly complained about pains in the lumbar (n = 36; 26%), shoulder (n = 27; 20%), and neck regions (n = 25; 18%). The driver's posture and the comfort of the seat were statistically significant for causing lower back and upper legs pains. The race duration was relevant to neck and shoulder discomfort. The high incidence of musculoskeletal injuries in race car driving indicates the need for further improvements. Elimination of driver complaints about pain in the spine and upper extremities can be achieved through technical development, as already accomplished in Formula One racing.

Epidemiological patterns of traumatic musculoskeletal injuries and non-traumatic disorders in Japan Self-Defense Forces.

PubMed

Amako, Masatoshi; Yato, Yoshiyuki; Yoshihara, Yasuo; Arino, Hiroshi; Sasao, Hiroshi; Nemoto, Osamu; Imai, Tomohito; Sugihara, Atsushi; Tsukazaki, Satoshi; Sakurai, Yutaka; Nemoto, Koichi

2018-05-01

The epidemiological patterns of musculoskeletal injuries or disorders in military personnel have not been well documented and a better understanding is required for proper preventative measures and treatment. Here, we investigated musculoskeletal injuries or disorders among members of the Japan Self-Defense Forces. All orthopedic patients (n = 22,340) who consulted to Japan Self-Defense Forces Hospitals were investigated for their type of injury or disorder, the injured body part, the mechanism, and the cause of injuries. Thirty-nine percent of the cases were classified as traumatic injuries, and 61% were classified as non-traumatic disorders. Of the traumatic injury patients, the injured body part was the upper extremity in 32%, the trunk in 23%, and the lower extremities in 45% of the cases. The most common injured body location was the knee followed by the hand/finger and ankle. Exercise was the most common cause of injury, followed by traffic accident and military training. Contusions were the most common traumatic injuries, followed by sprains and fractures. Of non-traumatic disorders, the lower extremities were reported as the injured part in 43% of the disorders. Lumbar spine disorders were the most common non-traumatic disorders, followed by tendon and joint disorders. Over one-third of orthopedic cases among members of the Japan Self-Defense Forces are traumatic injuries, with the knee being the body part most commonly injured and exercise being the leading cause of injury.

The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers.

PubMed

Lee, Jin Woo; Lee, Ju Jong; Mun, Hyeon Je; Lee, Kyung-Jae; Kim, Joo Ja

2013-10-11

To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants' socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work-related musculoskeletal symptoms. This study focused on structural risk factors in the working environment, such as the gender-based division of labor, shift work and labor intensity, that demonstrated a statistically significant correlation with the work-related musculoskeletal symptoms of hotel workers. Both men and women reported different prevalence rates of work-related musculoskeletal symptoms among different departments. This could indicate that a gender-based division of labor produces different ergonomic risk factors for each gender group. However, only females displayed a statistically significant correlation between shift work and labor intensity and musculoskeletal symptoms. Thus, minimizing ergonomic risk factors alone does not suffice to effectively prevent musculoskeletal diseases among hotel workers. Instead, work assignments should be based on gender, department, working hours and work intensity should be adjusted to address multi-dimensional musculoskeletal risk factors. In addition, an approach that seeks to minimize shift work is needed to reduce the incidence of musculoskeletal disorders.

The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers

PubMed Central

2013-01-01

Objectives To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. Methods A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants’ socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. Results The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work-related musculoskeletal symptoms. Conclusion This study focused on structural risk factors in the working environment, such as the gender-based division of labor, shift work and labor intensity, that demonstrated a statistically significant correlation with the work-related musculoskeletal symptoms of hotel workers. Both men and women reported different prevalence rates of work-related musculoskeletal symptoms among different departments. This could indicate that a gender-based division of labor produces different ergonomic risk factors for each gender group. However, only females displayed a statistically significant correlation between shift work and labor intensity and musculoskeletal symptoms. Thus, minimizing ergonomic risk factors alone does not suffice to effectively prevent musculoskeletal diseases among hotel workers. Instead, work assignments should be based on gender, department, working hours and work intensity should be adjusted to address multi-dimensional musculoskeletal risk factors. In addition, an approach that seeks to minimize shift work is needed to reduce the incidence of musculoskeletal disorders. PMID:24472690

Musculoskeletal impact of the use of various types of electronic devices on university students in Hong Kong: An evaluation by means of self-reported questionnaire.

PubMed

Woo, Eugenia H C; White, Peter; Lai, Christopher W K

2016-12-01

Despite the increasingly widespread popularity of electronic devices, there are limited comprehensive studies on the effects of usage and exposure to multiple electronic devices over extended periods of time. Therefore, this study explored the cumulative musculoskeletal implications of exposure to various electronic devices among university students. A self-reported questionnaire was administered in the university in Hong Kong and students provided information about the frequency and duration of electronic devices use, including computers, mobile phones and game consoles, and reported on any musculoskeletal pain or discomfort that may relate to electronic devices usage in the immediate 12 months prior to the survey date. A total of 503 university students (59% males and 41% females) aged 18-25 years completed the questionnaire. The results showed that 251 (49.9%) respondents reported upper limb musculoskeletal symptoms, particularly in the neck and shoulder regions. Among these, 155 (61.8%) indicated that their discomfort was related to electronic device usage. Statistically significant differences in exposure to electronic devices and musculoskeletal outcomes between genders were found (p < 0.05). The use of electronic devices and habitual postures were associated with musculoskeletal problems among university students in Hong Kong. This phenomenon highlights the urgent need for ergonomics education and recommendations to increase students' awareness of musculoskeletal wellbeing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Workplace interventions for preventing work disability.

PubMed

van Oostrom, Sandra H; Driessen, Maurice T; de Vet, Henrica C W; Franche, Renée-Louise; Schonstein, Eva; Loisel, Patrick; van Mechelen, Willem; Anema, Johannes R

2009-04-15

Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders. To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions. We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007). We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome. Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed. We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems. As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies.

Behavioral and psychophysiological responses to job demands and association with musculoskeletal symptoms in computer work.

PubMed

Griffiths, Karin Lindgren; Mackey, Martin G; Adamson, Barbara J

2011-12-01

The purpose of this study was to identify and compare individual behavioral and psychophysiological responses to workload demands and stressors associated with the reporting of musculoskeletal symptoms with computer work. Evidence is growing that the prevalence of musculoskeletal symptoms increases with longer hours of computer work and exposure to psychosocial stressors such as high workloads and unrealistic deadlines. Workstyle, or how an individual worker behaves in response to such work demands, may also be an important factor associated with musculoskeletal symptoms in computer operators. Approximately 8,000 employees of the Australian Public Service were invited to complete an on-line survey if they worked with a computer for 15 or more hours per week. The survey was a composite of three questionnaires: the ASSET to measure perceived organizational stressors, Nordic Musculoskeletal Questionnaire to measure reported prevalence of musculoskeletal symptoms and additional questions to measure individual work behaviors and responses. 934 completed surveys were accepted for analyses. Logistic regression was used to identify significant behavioral and work response predictors of musculoskeletal symptoms. Reporting of heightened muscle tension in response to workload pressure was more strongly associated, than other physical behavioral factors, with musculoskeletal symptoms for all body areas, particularly the neck (OR = 2.50, 95% CI: 2.09-2.99). Individual workstyles in response to workload demands and stressors, including working with heightened muscle tension and mental fatigue, were significantly associated with musculoskeletal symptoms. Future risk management strategies should have a greater focus on the identification and management of those organizational factors that are likely to encourage and exacerbate adverse workstyles.

Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study

PubMed Central

2011-01-01

Background The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. Methods The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. Results In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR) = 0.34, 95% confidence interval (95% CI) = 0.15 to 0.78, P = 0.011). This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047). In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0.29 to 1.04). Conclusions A neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army conscripts. A similar programme could be useful for all young individuals by initiating a regular exercise routine. Trial registration ClinicalTrials.gov identifier number NCT00595816. PMID:21481230

Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study.

PubMed

Parkkari, Jari; Taanila, Henri; Suni, Jaana; Mattila, Ville M; Ohrankämmen, Olli; Vuorinen, Petteri; Kannus, Pekka; Pihlajamäki, Harri

2011-04-11

The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service. The trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs. In the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR) = 0.34, 95% confidence interval (95% CI) = 0.15 to 0.78, P = 0.011). This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047). In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0.29 to 1.04). A neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army conscripts. A similar programme could be useful for all young individuals by initiating a regular exercise routine. ClinicalTrials.gov identifier number NCT00595816.

Ultrasonographic findings of Kimura's disease presenting in the upper extremities.

PubMed

Shin, Gi Won; Lee, Sun Joo; Choo, Hye Jung; Park, Young Mi; Jeong, Hae Woong; Lee, Sung-Moon; Suh, Jin-Suck; Jung, Soo-Jin

2014-12-01

To describe ultrasound findings of Kimura's disease arising in the upper extremities. Five patients with Kimura's disease confirmed by surgical resection were retrospectively reviewed by two musculoskeletal radiologists and a pathologist. All six lesions involved the epitrochlear area and appeared as partially (n = 5) or poorly (n = 1) marginated subcutaneous masses with the presence of curvilinear hyperechoic bands intermingled within the hypoechoic components by US. Moderate (n = 4) to severe (n = 2) vascular signals were observed in some proportion of the hyperechoic bands by color Doppler US. The associated findings were the increased echogenicity of surrounding subcutaneous fat (n = 6) and adjacent lymphadenopathy (n = 4). Microscopic examination showed proliferation of lymphoid follicles with prominent germinal centers and intervening fibrosis. In this study, Kimura's disease arising in the upper extremities showed a partially defined hypoechoic subcutaneous mass with internal hyperechoic bands and moderate-to-severe vascularities, increased echogenicity of the surrounding subcutaneous fat and adjacent lymphadenopathy on US. Thus, when these US features are observed in the typical epitrochlear region of an Asian individual, especially if accompanied by peripheral eosinophilia, Kimura's disease should be considered as a possible diagnosis.

Upper Limb Absence: Predictors of Work Participation and Work Productivity.

PubMed

Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

2016-06-01

To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). Cross-sectional study: postal survey (response rate, 45%). Twelve rehabilitation centers and orthopedic workshops. Individuals (n=207) with unilateral transverse upper limb reduction deficiency (RD) or acquired amputation (AA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of control subjects (n=90) matched on age and sex. Not applicable. Employment status, self-reported work productivity measured with the Quality-Quantity method, and self-reported upper extremity work demands measured with the Upper Extremity Work Demands scale. Seventy-four percent of the individuals with RD and 57% of the individuals with AA were employed (vs 82% of the control group and 66% of the general population). Male sex, younger age, a medium or higher level of education, prosthesis use, and good general health were predictors of work participation. Work productivity was similar to that of the control group. Higher work productivity was inversely related to musculoskeletal complaint-related pain. When having predominantly mentally demanding work, individuals with ULA perceived higher upper extremity work demands compared with controls. Work participation of individuals with RD was slightly higher compared with that of the general population, whereas employment rates of individuals with AA were slightly lower. Furthermore, work productivity did not differ between individuals with RD, AA, and controls. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of 'I-Preventive': a digital preventive tool for musculoskeletal disorders in computer workers-a pilot cluster randomised trial.

PubMed

Lanhers, C; Pereira, B; Garde, G; Maublant, C; Dutheil, F; Coudeyre, E

2016-09-22

I-Preventive is a digital preventive tool for musculoskeletal disorders (MSDs) in computer workers. We sought to determine its impact on pain in computer workers with upper limb MSDs and visual discomfort. We conducted a pilot cluster randomised trial in 2 different sites of a tyre factory in France. We randomised 200 employees to either an intervention group (I-Preventive) or control group, each comprising symptomatic and asymptomatic employees. The workers were followed up for 5 months. The main outcome was overall recovery from symptoms following 1 month's intervention based on Nordic-style and eyestrain questionnaires. We included 185/200 workers: 96 in the intervention group (mean age 41.8±1.4 years; 88.5% males) and 79 in the control group (mean age 42.9±12.0 years; 94.5% males). The most painful areas (numerical scale ≥2) were the neck (40.0%), upper back (18.8%) and shoulders (15.7%). For the most painful anatomical area, the Nordic score significantly decreased after 1 month in the intervention group (p=0.038); no change was observed in the control group (p=0.59). After 1 month's use, the intervention group reported less pain in the painful area and less visual discomfort symptoms (p=0.02). Adherence to the I-Preventive program was 60%. I-Preventive is effective in the short term on musculoskeletal symptoms and visual discomfort by promoting active breaks and eyestrain treatment. This easy-to-use digital tool allows each worker to focus on areas of their choice via personalised, easy exercises that can be performed in the workplace. NCT02350244; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

PubMed Central

Terwee, Caroline B.; van der Windt, Daniëlle A. W. M.; van der Beek, Allard J.; Bouter, Lex M.; Dekker, Joost

2007-01-01

Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale “worrying” the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale “worrying” (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. PMID:17410376

Investigation of musculoskeletal symptoms in a manufacturing company in Brazil: a cross-sectional study.

PubMed

Hembecker, Paula K; C Reis, Diogo; Konrath, Andréa C; A Gontijo, Leila; D Merino, Eugenio A

Musculoskeletal disorders are prevalent and represent the most common health problem among the working population in industrially-developing countries, with considerable costs and impact on quality of life. Despite the high incidence of disability insurance claims among Brazilian manufacturing-sector workers, only a few studies assessed musculoskeletal disorders prevalence. To provide information on the prevalence of musculoskeletal disorders among manufacturing-sector workers and to explore the relationship between musculoskeletal disorders and sociodemographic and occupational characteristics in a medium metallurgical company located in Brazil. A cross-sectional study was carried out. Data was collected through the use of a specifically-designed questionnaire and the items used to collect musculoskeletal disorders data were based on the Nordic Musculoskeletal Questionnaire. Descriptive statistics were used and multivariate logistic regression analysis (p<0.02) was performed to explore the associations between musculoskeletal disorders and potential risk factors. The upper limb was the most frequently affected body region among manufacturing-sector workers: shoulder (24.8%), elbow and/or forearm (15.5%), wrist and/or hand (19.0%). Adjusted logistic regression analysis showed that company experience (p=0.02), presence of sleep disorders (p=0.00), self-reported general health state (p=0.00) and perform work pause (p=0.00) were significant risk factors for development of musculoskeletal disorders. Sociodemographic and work-related aspects are influential risk factors for musculoskeletal disorders. These results add comprehension about musculoskeletal disorders prevalence and suggest a need for greater emphasis on prevention strategies. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Median and ulnar neuropathies in university guitarists.

PubMed

Kennedy, Rachel H; Hutcherson, Kimberly J; Kain, Jennifer B; Phillips, Alicia L; Halle, John S; Greathouse, David G

2006-02-01

Descriptive study. To determine the presence of median and ulnar neuropathies in both upper extremities of university guitarists. Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Guitarists and plucked-string musicians are at risk for entrapment neuropathies in the upper extremities and are prone to mild neurologic deficits. Twenty-four volunteer male and female guitarists (age range, 18-26 years) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Individuals were excluded if they were pregnant or had a history of recent upper extremity or neck injury. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. Six subjects had positive findings on provocative testing of the median and ulnar nerves. Otherwise, these guitarists had normal upper extremity neural and musculoskeletal function based on the history and physical examinations. When comparing the subjects' nerve conduction study values with a chart of normal nerve conduction studies values, 2 subjects had prolonged distal motor latencies (DMLs) of the left median nerve of 4.3 and 4.7 milliseconds (normal, < 4.2 milliseconds). Prolonged DMLs are compatible with median neuropathy at or distal to the wrist. Otherwise, all electrophysiological variables were within normal limits for motor, sensory, and F-wave (central) values. However, comparison studies of median and ulnar motor latencies in the same hand demonstrated prolonged differences of greater than 1.0 milliseconds that affected the median nerve in 2 additional subjects, and identified contralateral limb involvement in a subject with a prolonged distal latency. The other 20 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities. In this descriptive study of a population of 24 university guitarists, 4 musicians (17%) were found to have electrophysiologic evidence of median neuropathy at or distal to the wrist or carpal tunnel syndrome. Ulnar nerve electrophysiological function was within normal limits for all subjects examined.

Upper extremity pain and computer use among engineering graduate students.

PubMed

Schlossberg, Eric B; Morrow, Sandra; Llosa, Augusto E; Mamary, Edward; Dietrich, Peter; Rempel, David M

2004-09-01

The objective of this study was to investigate risk factors associated with persistent or recurrent upper extremity and neck pain among engineering graduate students. A random sample of 206 Electrical Engineering and Computer Science (EECS) graduate students at a large public university completed an online questionnaire. Approximately 60% of respondents reported upper extremity or neck pain attributed to computer use and reported a mean pain severity score of 4.5 (+/-2.2; scale 0-10). In a final logistic regression model, female gender, years of computer use, and hours of computer use per week were significantly associated with pain. The high prevalence of upper extremity pain reported by graduate students suggests a public health need to identify interventions that will reduce symptom severity and prevent impairment.

Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand: A Systematic Review

PubMed Central

Hardison, Mark E.

2017-01-01

Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity. It is imperative that practitioners understand the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purposeful occupations. This systematic review provides an update to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question, What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm, wrist, and hand? A total of 59 articles were reviewed. Evidence for interventions was synthesized by condition within bone, joint, and general hand disorders; peripheral nerve disorders; and tendon disorders. The strongest evidence supports postsurgical early active motion protocols and splinting for various conditions. Very few studies have examined occupation-based interventions. Implications for occupational therapy practice and research are provided. PMID:28027038

Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand: A Systematic Review.

PubMed

Roll, Shawn C; Hardison, Mark E

Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity. It is imperative that practitioners understand the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purposeful occupations. This systematic review provides an update to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question, What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm, wrist, and hand? A total of 59 articles were reviewed. Evidence for interventions was synthesized by condition within bone, joint, and general hand disorders; peripheral nerve disorders; and tendon disorders. The strongest evidence supports postsurgical early active motion protocols and splinting for various conditions. Very few studies have examined occupation-based interventions. Implications for occupational therapy practice and research are provided. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers.

PubMed

Boschman, J S; Noor, A; Lundström, R; Nilsson, T; Sluiter, J K; Hagberg, M

2017-08-01

The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later. We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used. Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p < 0.01) and lower handgrip strength (OR 0.91 p < 0.05) predicted future poor WA among office workers. Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

The correlation of osteoporosis to clinical features: a study of 4382 female cases of a hospital cohort with musculoskeletal symptoms in southwest China.

PubMed

Li, Shasha; He, Hongchen; Ding, Mingfu; He, Chengqi

2010-08-16

By analyzing the clinical features and risk factors in female patients with musculoskeletal symptoms of Southwest China, this report presents the initial analysis of characteristics in this region and compared with international evaluative criteria. Diagnosis of osteoporosis (OP) was made in female hospital patients age > or = 18 years admitted from January 1998 to December 2008 according to WHO definition. Case data were analyzed by symptoms, age, disease course and risk factors to reveal correlation with diagnosis of OP. Logistic regression was used to identify the risks of osteoporosis. A total of 4382 patients were included in the analysis of the baseline characteristics, among which 1455 in the OP group and 2927 in the non-OP group. The morbidity of OP is significantly increased in females' > or = 50 years. Both groups had symptoms related to pain and numbness; no significant difference was found in reported upper and lower back pain, or leg pain between two groups (p > 0.05). Neck, shoulder and arm pain, leg and arm numbness were more common in the non-osteoporosis group (p < 0.05, OR < 1, and upper limit of 95% CI of OR < 1). Hypertension, diabetes, hyperostosis were major risk factors for the patients with OP. The most common lifestyle-related risk factors for osteoporosis were smoking, body mass index, lack of physical activity and menopause. The present study offers the first reference data of the relationship between epidemiologic distribution of osteoporosis and associated factors in adults Chinese women. These findings provide a theoretical basis for its prevention and treatment in developing country.

Validity of Nordic-style questionnaires in the surveillance of upper-limb work-related musculoskeletal disorders

PubMed Central

Descatha, Alexis; Roquelaure, Yves; Chastang, Jean-François; Evanoff, Bradley; Melchior, Maria; Mariot, Camille; Ha, Catherine; Imbernon, Ellen; Goldberg, Marcel; Leclerc, Annette

2007-01-01

Objectives The study aimed to compare results of the standardized Nordic-style questionnaire to those of a clinical examination in two large surveys on upper-limb work-related musculoskeletal disorders (UWMSD). Methods The “Repetitive task” survey based on 1757 workers in 1993–1994 and 598 workers in 1996–1997 aimed at studying UWMSD risk factors in a population exposed to repetitive work. The “Pays de la Loire” survey, based on 2685 workers in 2002–2003, was part of a population-wide surveillance system. In both surveys, each worker completed a Nordic-style questionnaire and underwent a standardized clinical examination. Presence of at least one UWMSD was compared, with evaluation of sensitivity, specificity, and kappa value, considering clinical examination as the reference method. In the second survey, a score based on a numeric scale for severity of symptoms at the time of examination was evaluated in the same way (plus ROC curves). Results Agreement between questionnaire and examination was different in the two surveys: from kappa=0.22 [0.19–0.23] in the “Pays de la Loire” survey to 0.77 [0.74–0.80] in 1993–1994 in the “Repetitive task” survey. Sensitivity was excellent in all situations (from 82.3% to 100%). Specificity was variable, from 51.1% in the “Pays de la Loire” survey to 82.4% for score ≥ 2 based on the severity of symptoms in the survey. Conclusion Nordic-style questionnaires exploring symptoms in the past year can be considered as useful tools for surveillance of UWMSD, especially if they include numerical scales on symptom severity. Physical examination remains essential for a medical or clinical diagnosis assessment. PMID:17353966

Relationships of Musculoskeletal Symptoms, Sociodemographics, and Body Mass Index With Leisure-Time Physical Activity Among Nurses.

PubMed

Nam, Soohyun; Song, MinKyoung; Lee, Soo-Jeong

2018-05-01

Nurses have a high prevalence of musculoskeletal symptoms from patient handling tasks such as lifting, transferring, and repositioning. Comorbidities such as musculoskeletal symptoms may negatively affect engagement in leisure-time physical activity (LTPA). However, limited data are available on the relationship between musculoskeletal symptoms and LTPA among nurses. The purpose of this study was to describe musculoskeletal symptoms and LTPA, and to examine the relationships of musculoskeletal symptoms, sociodemographics, and body mass index with LTPA among nurses. Cross-sectional data on sociodemographics, employment characteristics, musculoskeletal symptoms, body mass index, and LTPA were collected from a statewide random sample of 454 California nurses from January to July 2013. Descriptive statistics, bivariate and multiple logistic regressions were performed. We observed that non-White nurses were less likely to engage in regular aerobic physical activity than White nurses (odds ratio [OR] = 0.61; 95% confidence interval [CI] = [0.40, 0.94]). Currently working nurses were less likely to engage in regular aerobic physical activity than their counterparts (OR = 0.48; 95% CI = [0.25, 0.91]). Nurses with higher body mass index were less likely to perform regular aerobic physical activity (OR = 0.93; 95% CI = [0.89, 0.97]) or muscle-strengthening physical activity (OR = 0.92; 95% CI = [0.88, 0.96]). This study found no evidence that musculoskeletal symptoms may interfere with regular engagement in LTPA. Physical activity promotion interventions should address employment-related barriers, and particularly target racial minority nurses and those who have a high body mass index.

Differences in physical workload, psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models.

PubMed

Unge, Jeannette; Ohlsson, Kerstina; Nordander, Catarina; Hansson, Gert-Ake; Skerfving, Staffan; Balogh, Istvan

2007-11-01

To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors. The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination. The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P<0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35 degrees/s vs 71 degrees/s; P<0.001) and wrist movements (20 degrees/s vs 27 degrees/s; P=0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P=0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P<0.001). Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.

Upper extremity disorders in heavy industry workers in Greece.

PubMed

Tsouvaltzidou, Thomaella; Alexopoulos, Evangelos; Fragkakis, Ioannis; Jelastopulu, Eleni

2017-06-18

To investigate the disability due to musculoskeletal disorders of the upper extremities in heavy industry workers. The population under study consisted of 802 employees, both white- and blue-collar, working in a shipyard industry in Athens, Greece. Data were collected through the distribution of questionnaires and the recording of individual and job-related characteristics during the period 2006-2009. The questionnaires used were the Quick Disabilities of the Arm, Shoulder and Hand (QD) Outcome Measure, the Work Ability Index (WAI) and the Short-Form-36 (SF-36) Health Survey. The QD was divided into three parameters - movement restrictions in everyday activities, work and sports/music activities - and the SF-36 into two items, physical and emotional. Multiple linear regression analysis was performed by means of the SPSS v.22 for Windows Statistical Package. The answers given by the participants for the QD did not reveal great discomfort regarding the execution of manual tasks, with the majority of the participants scoring under 5%, meaning no disability. After conducting multiple linear regression, age revealed a positive association with the parameter of restrictions in everyday activities (b = 0.64, P = 0.000). Basic education showed a statistically significant association regarding restrictions during leisure activities, with b = 2.140 ( P = 0.029) for compulsory education graduates. WAI's final score displayed negative charging in the regression analysis of all three parameters, with b = -0.142 ( P = 0.0), b = -0.099 ( P = 0.055) and b = -0.376 ( P = 0.001) respectively, while the physical and emotional components of SF-36 associated with movement restrictions only in daily activities and work. The participants' specialty made no statistically significant associations with any of the three parameters of the QD. Increased musculoskeletal disorders of the upper extremity are associated with older age, lower basic education and physical and mental/emotional health and reduced working ability.

Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort.

PubMed

Bout-Tabaku, Sharon; Michalsky, Marc P; Jenkins, Todd M; Baughcum, Amy; Zeller, Meg H; Brandt, Mary L; Courcoulas, Anita; Buncher, Ralph; Helmrath, Michael; Harmon, Carroll M; Chen, Mike K; Inge, Thomas H

2015-06-01

Obesity is associated with chronic musculoskeletal pain and is a risk factor for disability and osteoarthritis. To describe the prevalence, sites, and intensity of musculoskeletal pain in adolescents with severe obesity; to evaluate associations between musculoskeletal pain and self-reported physical function as well as weight-related quality of life; and to evaluate the association between musculoskeletal pain and high-sensitivity C-reactive protein level. Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) is a prospective, observational study that collects standardized data on adolescents undergoing weight loss surgery at 5 US centers. We examined baseline data from this cohort between February 28, 2007, and December 30, 2011. We excluded adolescents with Blount disease and slipped capital femoral epiphyses. A total of 233 participants were included in these analyses. We assessed musculoskeletal pain and pain intensity of the lower back, hips, knees, and ankles/feet using the visual analog scale, categorizing musculoskeletal pain into lower back pain, lower extremity (hips, knees, and feet/ankles combined) pain, and no pain. We assessed self-reported physical function status with the Health Assessment Questionnaire Disability Index and assessed weight-related quality of life with the Impact of Weight on Quality of Life-Kids measure. We adjusted for sex, race, age at surgery, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and clinical depressive symptoms in regression analyses. Among the 233 participants, the mean (SD) age at surgery was 17.1 (1.56) years and the median BMI was 50.4. Participants were predominantly female (77%), white (73%), and non-Hispanic (93%). Among the participants, 49% had poor functional status and 76% had musculoskeletal pain. Lower back pain was prevalent (63%), followed by ankle/foot (53%), knee (49%), and hip (31%) pain; 26% had pain at all 4 sites. In adjusted analyses, compared with pain-free participants, those reporting lower extremity pain had greater odds of having poor physical function according to scores on the Health Assessment Questionnaire Disability Index (odds ratio = 2.82; 95% CI, 1.35 to 5.88; P < .01). Compared with pain-free participants, those reporting lower extremity pain had significantly lower Impact of Weight on Quality of Life-Kids total scores (β = -9.42; 95% CI, -14.15 to -4.69; P < .01) and physical comfort scores (β = -17.29; 95% CI, -23.32 to -11.25; P < .01). After adjustment, no significant relationship was observed between musculoskeletal pain and high-sensitivity C-reactive protein level. Adolescents with severe obesity have musculoskeletal pain that limits their physical function and quality of life. Longitudinal follow-up will reveal whether weight loss surgery reverses pain and physical functional limitations and improves quality of life.

Daily computer usage correlated with undergraduate students' musculoskeletal symptoms.

PubMed

Chang, Che-Hsu Joe; Amick, Benjamin C; Menendez, Cammie Chaumont; Katz, Jeffrey N; Johnson, Peter W; Robertson, Michelle; Dennerlein, Jack Tigh

2007-06-01

A pilot prospective study was performed to examine the relationships between daily computer usage time and musculoskeletal symptoms on undergraduate students. For three separate 1-week study periods distributed over a semester, 27 students reported body part-specific musculoskeletal symptoms three to five times daily. Daily computer usage time for the 24-hr period preceding each symptom report was calculated from computer input device activities measured directly by software loaded on each participant's primary computer. General Estimating Equation models tested the relationships between daily computer usage and symptom reporting. Daily computer usage longer than 3 hr was significantly associated with an odds ratio 1.50 (1.01-2.25) of reporting symptoms. Odds of reporting symptoms also increased with quartiles of daily exposure. These data suggest a potential dose-response relationship between daily computer usage time and musculoskeletal symptoms.

Analyzing musculoskeletal system discomforts and risk factors in computer-using office workers.

PubMed

Ardahan, Melek; Simsek, Hatice

2016-01-01

This study analyzed the prevalence of work-related computer-user musculoskeletal discomforts, personal and computer-related risk factors. A cross-sectional survey on 395 office workers was made between July-September 2015. Musculoskeletal symptoms and risk factors were evaluated for participants' demographics and job attributes on the 21-item questionnaire and the Turkish-Cornell Musculoskeletal Discomfort Questionnaire. Participants reported musculoskeletal symptoms in the neck (67.85%), back (66.33%), lower back (59.49%), right shoulder (45.32%) and left shoulder (43.54%) during the past week and work interference was 33.6%, 28.5%, 30.6%, 31.3% and 31.9%, respectively. Musculoskeletal discomfort risks were being male, increasing daily computer usage, feeling computer-usage discomfort, hours working at desk and having knowledge about ergonomic exercises. Musculoskeletal symptoms are common in Turkish office workers and indicated the need for more attention to musculoskeletal disorders and designing effective preventive interventions.

Upper extremity access for fenestrated endovascular aortic aneurysm repair is not associated with increased morbidity.

PubMed

Knowles, Martyn; Nation, David A; Timaran, David E; Gomez, Luis F; Baig, M Shadman; Valentine, R James; Timaran, Carlos H

2015-01-01

Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives but frequently require bilateral upper extremity access that has been associated with a 3% to 10% risk of stroke. However, upper extremity access is also frequently required for FEVAR because of the caudal orientation of the visceral vessels. The purpose of this study was to assess the use of upper extremity access for FEVAR and the associated morbidity. During a 5-year period, 148 patients underwent FEVAR, and upper extremity access for FEVAR was used in 98 (66%). Outcomes were compared between those who underwent upper extremity access and those who underwent femoral access alone. The primary end point was a cerebrovascular accident or transient ischemic attack, and the secondary end point was local access site complications. The mean number of fenestrated vessels was 3.07 ± 0.81 (median, 3) for a total of 457 vessels stented. Percutaneous upper extremity access was used in 12 patients (12%) and open access in 86 (88%). All patients who required a sheath size >7F underwent high brachial open access, with the exception of one patient who underwent percutaneous axillary access with a 12F sheath. The mean sheath size was 10.59F ± 2.51F (median, 12F), which was advanced into the descending thoracic aorta, allowing multiple wire and catheter exchanges. One hemorrhagic stroke (one of 98 [1%]) occurred in the upper extremity access group, and one ischemic stroke (one of 54 [2%]) occurred in the femoral-only access group (P = .67). The stroke in the upper extremity access group occurred 5 days after FEVAR and was related to uncontrolled hypertension, whereas the stroke in the femoral group occurred on postoperative day 3. Neither patient had signs or symptoms of a stroke immediately after FEVAR. The right upper extremity was accessed six times without a stroke (0%) compared with the left being accessed 92 times with one stroke (1%; P = .8). Four patients (4%) had local complications related to upper extremity access. One (1%) required exploration for an expanding hematoma after manual compression for a 7F sheath, one (1%) required exploration for hematoma and neurologic symptoms after open access for a 12F sheath, and two patients (2%) with small hematomas did not require intervention. Two (two of 12 [17%]) of these complications were in the percutaneous access group, which were significantly more frequent than in the open group (two of 86 [2%]; P = .02). Upper extremity access appears to be a safe and feasible approach for patients undergoing FEVAR. Open exposure in the upper extremity may be safer than percutaneous access during FEVAR. Unlike chimney and snorkel grafts, upper extremity access during FEVAR is not associated with an increased risk of stroke, despite the need for multiple visceral vessel stenting. Copyright © 2015 Society for Vascular Surgery. All rights reserved.

The relationship between physical load and musculoskeletal complaints among Brazilian dentists.

PubMed

Oliveira Dantas, Filipe Fernandes; de Lima, Kenio Costa

2015-03-01

The aim of the present study was to assess the relationship between physical load and musculoskeletal complaints in dentistry and to analyze the prevalence and severity of such complaints in nine anatomical regions using a cross-sectional study of 387 dentists from Natal, Brazil. The highest prevalence of complaints was related to the lower back (58.4%) and the lowest prevalence was found in the elbow (10.3%). In general, symptoms were classified as mild because they did not cause absence due to illness. Pain complaints were associated with the following characteristics: awkward posture at work; prolonged standing or sitting; strenuous position of the upper limbs; excessive tightening of the hands during clinical treatment; and the use of vibrating tools. The results of the present study suggest a high prevalence of musculoskeletal complaints in dentists that are significantly associated with variables related to their physical workload. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

PubMed

Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

2003-08-01

An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

The Relaxation Response Resiliency Program (3RP) in Patients with Headache and Musculoskeletal Pain: A Retrospective Analysis of Clinical Data.

PubMed

Gonzalez, Adam; Shim, Minjung; Mahaffey, Brittain; Vranceanu, Ana-Maria; Reffi, Anthony; Park, Elyse R

2018-05-14

Headache and musculoskeletal pain are associated with both physical and mental health symptoms, which together are mutually reinforcing. Addressing mental and physical health symptoms (including pain) concomitantly may provide an effective and efficient way to improve outcomes in this population. We tested an evidence-based, eight-session multimodal group program, the Relaxation Response Resiliency Program (3RP), in patients with headache and musculoskeletal pain. A total of 109 adults (30 with headaches, 79 with musculoskeletal pain). Participant were 109 adults (30 with headaches, 79 with musculoskeletal pain) referred by their medical doctor, who completed a battery of questionnaires before and after completion of the 3RP. On average, patients with headache and musculoskeletal pain had higher pretreatment scores for anxiety, depression, and somatization symptoms than the nonpatient normative sample for the Symptom Checklist 90-Revised. Significant improvements were identified from pre- to post-treatment in all mental health symptoms (moderate to large effects) and frequency of pain and co-occurring physical health symptoms (small to moderate effects). Patients also reported significant decreases in degree of discomfort and life interference, which were relatively more modest in the musculoskeletal pain group compared with the headache group. Overall, results of this study suggest that the 3RP may be an effective treatment for reducing pain and psychological symptoms in patients with headaches and musculoskeletal pain. Future work is needed to evaluate the 3RP via a randomized clinical trial in these patient populations. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Musculoskeletal pain in Europe: role of personal, occupational and social risk factors

PubMed Central

Farioli, Andrea; Mattioli, Stefano; Quaglieri, Anna; Curti, Stefania; Violante, Francesco S; Coggon, David

2014-01-01

Objectives Prevalence of musculoskeletal pain in European countries varies considerably. We analyzed data from the fifth European Working Conditions Survey (EWCS) to explore the role of personal, occupational, and social risk factors in determining the national prevalence of musculoskeletal pain. Methods During 2010, 43,816 subjects from 34 countries were interviewed. We analyzed the one-year prevalence of back and neck/upper limb pain. Personal risk factors studied were: sex; age; educational level; socio-economic status; housework or cooking; gardening and repairs; somatising tendency; job demand-control; six physical occupational exposures; and occupational group. Data on national socio-economic risk factors were obtained from eurostat and were available for 29 countries. We fitted Poisson regression models with random intercept on country. Results 35,550 workers entered the main analysis. Among personal risk factors, somatising tendency was the strongest predictor of the symptoms. Major differences were observed by country with back pain more than twice as common in Portugal (63.8%) as Ireland (25.7%), and prevalence rates of neck/upper limb pain ranging from 26.6% in Ireland to 67.7% in Finland. Adjustment by personal risk factors slightly reduced the large variation of prevalence between countries. For back pain, the rates were more homogenous after adjustment for social risk factors. Conclusions Our analysis indicates substantial variation between European countries in the prevalence of back and neck/upper limb pain. This variation is unexplained by established individual risk factors. It may be attributable in part to socio-economic differences between countries, with higher prevalence where there is less poverty and more social support. PMID:24009006

Serum dehydroepiandrosterone sulphate, psychosocial factors and musculoskeletal pain in workers.

PubMed

Marinelli, A; Prodi, A; Pesel, G; Ronchese, F; Bovenzi, M; Negro, C; Larese Filon, F

2017-12-30

The serum level of dehydroepiandrosterone sulphate (DHEA-S) has been suggested as a biological marker of stress. To assess the association between serum DHEA-S, psychosocial factors and musculoskeletal (MS) pain in university workers. The study population included voluntary workers at the scientific departments of the University of Trieste (Italy) who underwent periodical health surveillance from January 2011 to June 2012. DHEA-S level was analysed in serum. The assessment tools included the General Health Questionnaire (GHQ) and a modified Nordic musculoskeletal symptoms questionnaire. The relation between DHEA-S, individual characteristics, pain perception and psychological factors was assessed by means of multivariable linear regression analysis. There were 189 study participants. The study population was characterized by high reward and low effort. Pain perception in the neck, shoulder, upper limbs, upper back and lower back was reported by 42, 32, 19, 29 and 43% of people, respectively. In multivariable regression analysis, gender, age and pain perception in the shoulder and upper limbs were significantly related to serum DHEA-S. Effort and overcommitment were related to shoulder and neck pain but not to DHEA-S. The GHQ score was associated with pain perception in different body sites and inversely to DHEA-S but significance was lost in multivariable regression analysis. DHEA-S was associated with age, gender and perception of MS pain, while effort-reward imbalance dimensions and GHQ score failed to reach the statistical significance in multivariable regression analysis. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Risk factors for upper-extremity musculoskeletal disorders in the working population

PubMed Central

Roquelaure, Yves; Ha, Catherine; Rouillon, Clarisse; Fouquet, Natacha; Leclerc, Annette; Descatha, Alexis; Touranchet, Annie; Goldberg, Marcel; Imbernon, Ellen

2009-01-01

SUMMARY Objective The study aimed to assess the relative importance of personal and occupational risk factors for upper-extremity musculoskeletal disorders (UEMSDs) in the working population. Methods A total of 3,710 workers (58% of men) participating in a surveillance program of MSDs in a French region in 2002–2005 were included. UEMSDs were diagnosed by 83 trained occupational physicians performing a standardized physical examination. Personal factors and work exposure were assessed by a self-administered questionnaire. Statistical associations between MSDs, personal and occupational factors were analyzed using logistic regression modeling. Results A total of 472 workers suffered from at least one UEMSD. The risk of UEMSDs increased with age for both genders (P<0.001) (O.R. up to 4.9 in men and 5.0 and in women) and in cases of prior history of UEMSDs (OR 3.1 and 5.0, P<0.001). In men, UEMSDs were associated with obesity (OR 2.2, P=0.014), high level of physical demand (OR 2.0, P<0.001), high repetitiveness of the task (OR 1.5, P=0.027), postures with the arms at or above shoulder level (OR 1.7, P=0.009) or with full elbow flexion (OR 1.6, P=0.006), and high psychological demand (O.R. 1.5, P=0.005). In women, UEMSDs were associated with diabetes mellitus (O.R. 4.9, P=0.001), postures with extreme wrist bending (OR 2.0, P<0.001), use of vibrating hand tools (O.R. 2.2, P=0.025) and low level of decision authority (OR 1.4, P=0.042). Conclusion The study showed that personal and work-related physical and psychosocial factors were strongly associated with clinically-diagnosed UEMSDs. PMID:19790112

Musculoskeletal symptoms among female garment factory workers in Sri Lanka.

PubMed

Lombardo, Sarah R; Vijitha de Silva, P; Lipscomb, Hester J; Ostbye, Truls

2012-01-01

To assess the prevalence of musculoskeletal symptoms and their association with sociodemographic risk factors among female garment factory workers in Sri Lanka. 1058 randomly selected female garment factory workers employed in the free trade zone of Kogalla, Sri Lanka were recruited to complete two interviewer-administered questionnaires assessing musculoskeletal symptoms and health behaviors. Musculoskeletal complaints among female garment workers in the FTZ of Kogalla are less common than expected. Sociocultural factors may have resulted in underreporting and similarly contribute to the low rates of healthcare utilization by these women. 164 (15.5%) of workers reported musculoskeletal symptoms occurring more than 3 times or lasting a week or more during the previous 12-month period. Back (57.3%) and knee (31.7%) were the most common sites of pain. Although most symptomatic women reported that their problems interfered with work and leisure activities, very few missed work as a result of their pain. Prevalence correlated positively with increased age and industry tenure of less than 12 months. Job type, body mass index, and education were not significant predictors of musculoskeletal symptoms.

Stochastic resonance training reduces musculoskeletal symptoms in metal manufacturing workers: a controlled preventive intervention study.

PubMed

Burger, Christian; Schade, Volker; Lindner, Christina; Radlinger, Lorenz; Elfering, Achim

2012-01-01

This study examined the effects of stochastic resonance whole-body vibration training on work-related musculoskeletal symptoms and accidents. Participants were white and blue-collar employees of a Swiss metal manufacturer (N=38), and participation was voluntary. The study was designed as a switching-replications longitudinal trial with randomized group allocation. The randomized controlled cross-over design consisted of two groups each given four weeks of exercise and no intervention during a second four-week period. Outcome was measured on a daily basis with questionnaires. Three components constituted musculoskeletal symptoms: musculoskeletal pain, related function limitations and musculoskeletal well-being. Accidents were assessed by ratings for balance and daily near-accidents. For statistical analysis, a mixed model was calculated. At the end of the training period musculoskeletal pain and related function limitation were significantly reduced, whereas musculoskeletal well-being had significantly increased. For function limitation and musculoskeletal well-being, change over time was linear. There was no effect on balance or near-accidents. Stochastic resonance whole-body vibration was found to be effective in the prevention of work-related musculoskeletal symptoms. It is well suited for the use in a work environment since it requires very little effort in terms of infrastructure, time and investment from participants.

Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents

PubMed Central

2013-01-01

Background Type D personality, or the “distressed personality”, is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods A population-based, self-reported cross-sectional study conducted in Västmanland, Sweden with a cohort of 5012 students in the age between 15–18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Västmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well. Results There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p = < 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found. Conclusions There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents. PMID:23336535

Validity of the Dictionary of Occupational Titles for Assessing Upper Extremity Work Demands

PubMed Central

Opsteegh, Lonneke; Soer, Remko; Reinders-Messelink, Heleen A.; Reneman, Michiel F.; van der Sluis, Corry K.

2010-01-01

Objectives The Dictionary of Occupational Titles (DOT) is used in vocational rehabilitation to guide decisions about the ability of a person with activity limitations to perform activities at work. The DOT has categorized physical work demands in five categories. The validity of this categorization is unknown. Aim of this study was to investigate whether the DOT could be used validly to guide decisions for patients with injuries to the upper extremities. Four hypotheses were tested. Methods A database including 701 healthy workers was used. All subjects filled out the Dutch Musculoskeletal Questionnaire, from which an Upper Extremity Work Demands score (UEWD) was derived. First, relation between the DOT-categories and UEWD-score was analysed using Spearman correlations. Second, variance of the UEWD-score in occupational groups was tested by visually inspecting boxplots and assessing kurtosis of the distribution. Third, it was investigated whether occupations classified in one DOT-category, could significantly differ on UEWD-scores. Fourth, it was investigated whether occupations in different DOT-categories could have similar UEWD-scores using Mann Whitney U-tests (MWU). Results Relation between the DOT-categories and the UEWD-score was weak (rsp = 0.40; p<.01). Overlap between categories was found. Kurtosis exceeded ±1.0 in 3 occupational groups, indicating large variance. UEWD-scores were significantly different within one DOT-category (MWU = 1.500; p<.001). UEWD scores between DOT-categories were not significantly different (MWU = 203.000; p = .49). Conclusion All four hypotheses could not be rejected. The DOT appears to be invalid for assessing upper extremity work demands. PMID:21151934

The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review

PubMed Central

Toh, Siao Hui; Coenen, Pieter; Howie, Erin K.

2017-01-01

Background The use of mobile touch screen devices (MTSDs) has increased rapidly over the last decade, and there are concerns that their use may have negative musculoskeletal consequences; yet evidence on the association of MTSD use with musculoskeletal symptoms and exposures is currently dispersed. The aim of this study was to systematically review available literature on musculoskeletal symptoms and exposures associated with MTSD use. The synthesised information may facilitate wise use of MTSDs and may identify areas in need of further research. Methods EMBASE, Medline, Scopus, PsycINFO and Proquest electronic databases were searched for articles published up to June 2016, using keywords describing MTSD, musculoskeletal symptoms (e.g. pain, discomfort) and musculoskeletal exposures (e.g. posture, muscle activity). Two reviewers independently screened the articles, extracted relevant data and assessed methodological quality of included studies. Due to heterogeneity in the studies, a meta-analysis was not possible and a structured narrative synthesis of the findings was undertaken. Results A total of 9,908 articles were screened for eligibility with 45 articles finally included for review. Included articles were of cross-sectional, case-control or experimental laboratory study designs. No longitudinal studies were identified. Findings were presented and discussed in terms of the amount, features, tasks and positions of MTSD use and its association with musculoskeletal symptoms and musculoskeletal exposures. Conclusions There is limited evidence that MTSD use, and various aspects of its use (i.e. amount of usage, features, tasks and positions) are associated with musculoskeletal symptoms and exposures. This is due to mainly low quality experimental and case-control laboratory studies, with few cross-sectional and no longitudinal studies. Further research is warranted in order to develop guidelines for wise use of MTSDs. PMID:28787453

Associations between musculoskeletal pain and work-related factors among public service sector computer workers in Kaunas County, Lithuania.

PubMed

Kaliniene, Gintare; Ustinaviciene, Ruta; Skemiene, Lina; Vaiciulis, Vidmantas; Vasilavicius, Paulius

2016-10-07

Information technologies in occupational activities have been developing very rapid. Epidemiological studies have shown that musculoskeletal disorders are widely prevalent among employees working with a computer. The aim of this study was to evaluate the prevalence of musculoskeletal pain in various anatomical areas and its associations with individual, ergonomic, and psychosocial factors among computer workers of the public sector in Kaunas County, Lithuania. The investigation consisting of two parts - questionnaire study (Nordic Musculoskeletal Questionnaire and Copenhagen Psychosocial Questionnaire) and direct observation (evaluation of work ergonomics using the Rapid Upper Limb Assessment [RULA]) - was carried out in three randomly selected public sector companies of Kaunas County. The representative study sample comprised 513 public service office workers. The prevalence of musculoskeletal pain in five anatomical areas of the body (shoulders, elbows, wrists/hands, as well as upper and low back) was evaluated. The prevalence rates of shoulder, elbow, wrist/hand, upper and low back pain were 50.5 %, 20.3 %, 26.3 %, 44.8 %, and 56.1 %, respectively. Individual factors such as gender, age, computer work experience, and body mass index were found as significant for musculoskeletal pain in various musculoskeletal regions. The respondents reporting pain in shoulder, wrist/hand, upper back, and low back areas had a statistically significantly higher mean RULA score. The duration of working with a computer was found as a significant factor for shoulder pain. High quantitative demands were related to musculoskeletal pain in all investigated anatomical areas expect for the low back; weak social support was a significant predictor for complaints in upper and low back areas. This study confirmed associations between musculoskeletal pain and work ergonomics; therefore, preventive measures at the workplace should be directed to the improvement in ergonomic work environment, education, and workload optimization.

Variability in Wheelchair Propulsion: A New Window into an Old Problem

PubMed Central

Sosnoff, Jacob J.; Rice, Ian M.; Hsiao-Wecksler, Elizabeth T.; Hsu, Iris M. K.; Jayaraman, Chandrasekaran; Moon, Yaejin

2015-01-01

Manual wheelchair users are at great risk for the development of upper extremity injury and pain. Any loss of upper limb function due to pain adversely impacts the independence and mobility of manual wheelchair users. There is growing theoretical and empirical evidence that fluctuations in movement (i.e., motor variability) are related to musculoskeletal pain. This perspectives paper discusses a local review on several investigations examining the association between variability in wheelchair propulsion and shoulder pain in manual wheelchair users. The experimental data reviewed highlights that the variability of wheelchair propulsion is impacted by shoulder pain in manual wheelchair users. We maintain that inclusion of these metrics in future research on wheelchair propulsion and upper limb pain may yield novel data. Several promising avenues for future research based on this collective work are discussed. PMID:26284239

Work-Related Musculoskeletal Symptoms Among Batik Workers in Kelantan

PubMed Central

Musa, Razlan; Kyi, Win; Rampal, K.G

2000-01-01

A cross sectional study was carried out to evaluate the extent of occupational health problems focusing on some aspects of musculoskeletal symptoms among batik workers in Kelantan, Malaysia. The workers selected must have been in that industry for at least one year. Using cluster sampling, 202 workers were selected from 21 factories. More than half (60.2%) of the workers had been troubled with musculoskeletal symptoms at work. The most common symptoms were pain over the shoulders (41.0%), lower back (34.4%) and ankle (34.4%). Duration of employment, younger age group, prolonged standing and awkward working task were among contributing factors. It is therefore necessary to improve on both ergonomic and psychosocial environments of batik workers in order to prevent these musculoskeletal symptoms. PMID:22977385

Risk factors associated with upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy.

PubMed

Wu, Feng L; Sun, Yu; Pan, Sheng F; Zhang, Li; Liu, Zhong J

2014-06-01

Postoperative paresis, so-called C5 palsy, of the upper extremities is a common complication of cervical surgery. There have been several reports about upper extremity palsy after cervical laminoplasty for patients with cervical myelopathy. However, the possible risk factors remain unclear. To investigate the factors associated with the development of upper extremity palsy after expansive open-door laminoplasty for cervical myelopathy. A retrospective review of medical records. A total of 102 patients (76 men and 26 women) were eligible for analysis in this study. The mean age of the patients was 58.7 years (range 35-81 years). Sixteen patients (13 men and 3 women, average age 62.8 years) with palsy were categorized as Group P, and eighty-six patients (63 men and 23 women, average age 57.8 years) without palsy as Group C. The demographic data collected from both groups were age, sex, duration of symptoms, disease, and type of surgical procedure. Cervical curvature index, width of the intervertebral foramen (WIF) at C5, anterior protrusion of the superior articular process (APSAP), number of compressed segments, high-signal intensity zone at the level corresponding to C3-C5 (HIZ:C3-C5), and posterior shift of the spinal cord (PSSC) were also evaluated. Upper extremity palsy was defined as weakness of Grade 4 or less of the key muscles in the upper extremity by manual muscle test without any deterioration of myelopathic symptoms after surgery. Comparisons were made with screen for the parameters with significant differences, and then we further analyzed these parameters by logistic regression analysis (the forward method) to verify the risk factors of the upper extremity palsy. Significant differences in diagnosis, the type of procedure, WIF, APSAP, and HIZ:C3-C5 were observed between the two groups. No statistical difference in PSSC between the groups was noted (2.06 vs. 2.53 mm, p=.247). In logistic regression analysis, ossification of the posterior longitudinal ligament (OPLL), cervical open-door laminoplasty together with posterior instrumented fusion (CLP+PIF), and WIF were found to be significant risk factors for postoperative upper extremity palsy. Patients with preoperative foraminal stenosis, OPLL, and additional iatrogenic foraminal stenosis because of CLP+PIF were more likely to develop postoperative upper extremity palsy. Attention should be given to the WIF determined on preoperative computed tomography of the C5 root. To prevent iatrogenic foraminal stenosis, appropriate distraction between spine segments should be provided during placement of the rod. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of a prevention index to identify industries at high risk for work-related musculoskeletal disorders of the neck, back, and upper extremity in Washington state, 1990-1998.

PubMed

Silverstein, Barbara; Viikari-Juntura, Eira; Kalat, John

2002-03-01

The prevention of work-related musculoskeletal disorders such as carpal tunnel syndrome and low back disorders has been a focus of international prevention efforts including regulation. This study examines workers compensation claims in Washington State to provide baseline data from which to assess the need and the effects of prevention activities. Washington State Fund workers compensation claims for general and selected specific hand/wrist, elbow, shoulder, and back disorders in 1990-1998 as well as general self-insured compensable (four or more lost workdays) claims data were examined. Payroll hours were used to calculate claims incidence rates per 10,000 full-time equivalent employees (FTEs). We created a prevention index (PI) to rank industries by averaging the ranks of their number of claims and their claims incidence rate. The focus was on non-traumatic soft tissue musculoskeletal disorders (NTST-MSDs). Between 1990-1998, there were 392,925 State Fund accepted claims for NTST-MSDs of the neck, back, and upper extremity resulting in $2.6 billion in direct costs and 20.5 million lost workdays. The average claims incidence rate (CIR) was 355 NTST-MSDs per 10,000 FTEs. The NTST-MSD CIR decreased significantly less than that for all other claims (P = 0.05) but the CIR for upper extremity NTST-MSDs did not significantly decrease over the study period. There were no significant changes in the CIRs for sciatica (4.9 per 10,000 FTEs) and rotator cuff syndrome (15.3 per 10,000 FTEs), whereas the CIR for epicondylitis (10.6 per 10,000 FTEs) increased and for carpal tunnel syndrome (24.5 per 10,000 FTEs) decreased significantly over the study period. Based on the prevention index, the top five industries for combined State Fund and Self-Insured Compensable NTST-MSDs were Trucking and Courier Services (SIC 421), Nursing Homes (SIC 805), Masonry (SIC 174), Air Transportation (SIC 451), and Residential Construction (SIC 152). Using Washington Industrial Classes (WIC), temporary workers in assembly and administrative services were also high on the prevention index. NTST-MSDs continue to be a large and costly problem in Washington State. While the incidence rates for some NTST-MSDs are decreasing, the overall rate is not decreasing as fast as the rate for all other claims. In some cases, the rate is stable (sciatica, rotator cuff syndrome) or increasing (epicondylitis). Heavy manual handling and repetitive work characterize the industries with the highest risk. Copyright 2002 Wiley-Liss, Inc.

Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations.

PubMed

Krucoff, Max O; Cook, Steven; Adogwa, Owoicho; Moreno, Jessica; Yang, Siyun; Xie, Jichun; Firempong, Alexander O; Lad, Nandan; Bagley, Carlos A

2017-01-01

To examine the influence of race, gender, and socioeconomic factors on presentations and outcomes of adult Chiari I malformations. The charts of 638 adult patients with Chiari I malformations were reviewed, and 287 patients were included in the study. Race, gender, insurance status, symptoms, depth of cerebellar tonsillar herniation, and presence of syringomyelia were examined as covariates in multivariate logistic regression models to identify independent predictors of presentation and outcome. Patients with public insurance had a longer stay in the hospital (P = 0.01). A higher proportion of male patients presented with upper extremity weakness (P = 0.01), lower extremity weakness (P = 0.040), and cranial nerve findings (P = 0.02). Men had shorter onset to diagnosis times (P = 0.02), worse tonsillar herniation (P = 0.03), and more severe symptoms (P = 0.05). White patients more frequently presented with back pain (P = 0.03), and African American patients more frequently presented with lower extremity weakness (P = 0.01). African Americans had worse tonsillar herniation (P < 0.01) and were more likely to present with syringomyelia (P = 0.01). Multivariate regression analysis revealed that back pain (P < 0.01), upper extremity weakness (P ≤ 0.01), upper extremity paresthesias (P < 0.01), and upper with lower extremity paresthesias (P = 0.04) were significant predictors of syringomyelia. The only independent predictor of outcome was size of tonsillar herniation (P = 0.03). Significant differences in presentation of Chiari I malformation resulting from gender, race, and insurance status were quantified for the first time. Copyright © 2016 Elsevier Inc. All rights reserved.

Musculoskeletal Pain, Self-reported Physical Function, and Quality of Life in the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Cohort

PubMed Central

Bout-Tabaku, Sharon; Michalsky, Marc P.; Jenkins, Todd M.; Baughcum, Amy; Zeller, Meg H.; Brandt, Mary L.; Courcoulas, Anita; Buncher, Ralph; Helmrath, Michael; Harmon, Carroll M.; Chen, Mike K.; Inge, Thomas H.

2015-01-01

IMPORTANCE Obesity is associated with chronic musculoskeletal pain and is a risk factor for disability and osteoarthritis. OBJECTIVES To describe the prevalence, sites, and intensity of musculoskeletal pain in adolescents with severe obesity; to evaluate associations between musculoskeletal pain and self-reported physical function as well as weight-related quality of life; and to evaluate the association between musculoskeletal pain and high-sensitivity C-reactive protein level. DESIGN, SETTING, AND PARTICIPANTS Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) is a prospective, observational study that collects standardized data on adolescents undergoing weight loss surgery at 5 US centers. We examined baseline data from this cohort between February 28, 2007, and December 30, 2011. We excluded adolescents with Blount disease and slipped capital femoral epiphyses. A total of 233 participants were included in these analyses. MAIN OUTCOMES AND MEASURES We assessed musculoskeletal pain and pain intensity of the lower back, hips, knees, and ankles/feet using the visual analog scale, categorizing musculoskeletal pain into lower back pain, lower extremity (hips, knees, and feet/ankles combined) pain, and no pain. We assessed self-reported physical function status with the Health Assessment Questionnaire Disability Index and assessed weight-related quality of life with the Impact of Weight on Quality of Life–Kids measure. We adjusted for sex, race, age at surgery, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and clinical depressive symptoms in regression analyses. RESULTS Among the 233 participants, the mean (SD) age at surgery was 17.1 (1.56) years and the median BMI was 50.4. Participants were predominantly female (77%), white (73%), and non-Hispanic (93%). Among the participants, 49% had poor functional status and 76% had musculoskeletal pain. Lower back pain was prevalent (63%), followed by ankle/foot (53%), knee (49%), and hip (31%) pain; 26% had pain at all 4 sites. In adjusted analyses, compared with pain-free participants, those reporting lower extremity pain had greater odds of having poor physical function according to scores on the Health Assessment Questionnaire Disability Index (odds ratio = 2.82; 95% CI, 1.35 to 5.88; P < .01). Compared with pain-free participants, those reporting lower extremity pain had significantly lower Impact of Weight on Quality of Life–Kids total scores (β = −9.42; 95% CI, −14.15 to −4.69; P < .01) and physical comfort scores (β = −17.29; 95% CI, −23.32 to −11.25; P < .01). After adjustment, no significant relationship was observed between musculoskeletal pain and high-sensitivity C-reactive protein level. CONCLUSIONS AND RELEVANCE Adolescents with severe obesity have musculoskeletal pain that limits their physical function and quality of life. Longitudinal follow-up will reveal whether weight loss surgery reverses pain and physical functional limitations and improves quality of life. PMID:25915190

Chronic symptoms in construction workers treated for musculoskeletal injuries.

PubMed

Welch, L S; Hunting, K L; Nessel-Stephens, L

1999-11-01

Soft tissue musculoskeletal injuries make up a high proportion of all work-related injuries in construction. Data from Workers' Compensation claims indicate that strains and sprains are the leading compensable injury for construction workers. This study describes the consequences of soft tissue musculoskeletal injuries for construction workers, and assesses the persistence of symptoms after an injury and the impact of that injury on return to work. Through an Emergency Department surveillance system [Hunting et al., 1994a], we recorded 176 construction worker visits, from 5/01/93 through 2/28/95, for strains, sprains, joint injury or pain, tendinitis, dislocations, hernias, or other musculoskeletal injuries excluding fractures. Telephone interviews were conducted several months after workers had visited the emergency room for a musculoskeletal injury. Seventy individuals were interviewed about the long-term impacts of 72 incidents that had resulted in work-related musculoskeletal injuries. For 46 (62%) of the 74 diagnoses, problems continued beyond two months. The likelihood of problems continuing more than two months varied considerably by body location of injury. Hispanic workers and older workers were more likely to have continuing symptoms. Eleven of the 45 construction workers with symptoms persisting longer than two months were not employed at the time of the interview. Only 11 of the 45 workers with ongoing symptoms told us that modifications had been made to their jobs to accommodate their symptoms. About one-quarter of these 45 subjects reported substantial effects on home or work life. Acute musculoskeletal injuries in construction workers frequently result in chronic symptoms, and those with chronic symptoms report substantial effects of the injury on their quality of life. Job accommodations were made in a minority of these injuries. These findings point to the need for heightened efforts for injury prevention in this industry. Copyright 1999 Wiley-Liss, Inc.

Effects of a PRECEDE-PROCEED model based ergonomic risk management programme to reduce musculoskeletal symptoms of ICU nurses.

PubMed

Sezgin, Duygu; Esin, M Nihal

2018-08-01

To evaluate effects of a PRECEDE-PROCEED Model based, nurse-delivered Ergonomic Risk Management Program (ERMP) in the aim of reducing musculoskeletal symptoms of intensive care unit (ICU) nurses. This pre-test post-test design for non-equivalent control groups study comprised 72 ICU nurses from two hospitals. A randomised sampling was done through the study population. The ERMP was delivered as an intervention including 26weeks of follow-up. Data was collected by "Descriptives of Nurses and Ergonomic Risk Reporting Form", "Rapid Upper Risk Assessment Form (RULA)", "ICU Environment Assessment Form" and "Personal interviews form". There was no difference between sociodemographic characteristics, work and general health conditions within intervention and control group. One month after the intervention, nurses had significant decrease in their total RULA scores during bending down and patient repositioning movements as 1.40 and 0.82, respectively. Six months after the ERMP, the mean total RULA scores of nurses during the patient repositioning was 4.39±1.49 which meant "immediate further analyses and modifications recommended". After all, pain intensity scores, medication use due to pain, and RULA ergonomic risk scores were significantly decreased, while exercise frequency was increased. The ERMP was effective to increase exercise frequency and to decrease musculoskeletal pain and ergonomic risk levels of ICU nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of adolescent online gaming time and motives on depressive, musculoskeletal, and psychosomatic symptoms.

PubMed

Hellström, Charlotta; Nilsson, Kent W; Leppert, Jerzy; Åslund, Cecilia

2015-01-01

To investigate whether adolescent online gaming time and the additive effect of gaming motives were associated with depressive, musculoskeletal, and psychosomatic symptoms. The hypothesis was that adolescents who engage in online gaming with escape motives and increased online gaming time have higher probability for depressive, musculoskeletal, and psychosomatic symptoms compared to adolescents with other online gaming motives and/or less online gaming time. An anonymous and voluntary questionnaire was completed during class hours by 7,757 Swedish adolescents aged 13-18 years. The questionnaire included demographic background, gaming habits, and depressive, musculoskeletal, and psychosomatic symptoms. It was found that increased online gaming time during weekdays increased the probability of having depressive, musculoskeletal, and psychosomatic symptoms. However, these relations with time spent gaming were further explained by online gaming motives. Weekday online gaming for more than five hours a day, in combination with escape motives, was associated with an increased probability of depressive symptoms (odds ratio (OR) 4.614, 95% CI 3.230-6.590), musculoskeletal symptoms (OR 2.494, 95% CI 1.598-3.892), and psychosomatic symptoms (OR 4.437, 95% CI 2.966-6.637). The probability of ill health decreased when gaming was for fun or had social motives. Excessive gaming time and escape motives were found to be associated with increased probability of ill health among adolescents. Gaming motives may identify gamers in need of support to reduce unhealthy gaming behaviour as well as identify individuals at risk for ill health.

Prevalence of work-related musculoskeletal disorders among sonographers in China: results from a national web-based survey

PubMed Central

Zhang, Danying; Huang, Hanlin

2017-01-01

Objectives: The aims of present study were to determine the prevalence of work-related musculoskeletal disorders (WRMSDs) among sonographers in China and to provide evidence for appropriate intervention measures to be taken. Methods: A self-reported questionnaire was used to screen WRMSDs experienced by sonographers during the past 12 months. This questionnaire survey was created and hosted on the WeChat official account platform for sonographers. Results: In the present study, 567 sonographers from 521 medical institutions completed the questionnaire. The vast majority (99.3%) of respondents reported experiencing symptoms of WRMSDs for at least one body region during the past 12 months. Work-related musculoskeletal pain or discomfort was most frequently reported for the neck (95.1%), right shoulder (84.1%), lower back (82.4%), right wrist/hand (81.0%), upper back (78.1%), right forearm/elbow (72.0%), and left shoulder (66.1%). Scanning hours per day, number of patients per day, and years of experience were positively associated with the occurrence and frequency of experiencing WRMSDs of some common and specific anatomical regions. Taking a regular rest break during the scanning working day was associated with a reduction of WRMSDs of the right shoulder and right wrist/hand. Adopting a sitting posture while performing scanning was associated with a reduction of WRMSDs, particularly for the lower back and the neck. Performing regular physical activity during leisure time was associated with a reduction of WRMSDs of the neck. Conclusions: The prevalence of WRMSDs among sonographers in China was extremely high. It is necessary and essential to reduce the number of scanning hours and patients per day, adopt a sitting posture while performing scanning, schedule regular rest breaks during the scanning working day, and encourage performance of regular physical activity during leisure time to alleviate this WRMSD issue experienced by sonographers. PMID:28904258

Prevalence of work-related musculoskeletal disorders among sonographers in China: results from a national web-based survey.

PubMed

Zhang, Danying; Huang, Hanlin

2017-11-25

The aims of present study were to determine the prevalence of work-related musculoskeletal disorders (WRMSDs) among sonographers in China and to provide evidence for appropriate intervention measures to be taken. A self-reported questionnaire was used to screen WRMSDs experienced by sonographers during the past 12 months. This questionnaire survey was created and hosted on the WeChat official account platform for sonographers. In the present study, 567 sonographers from 521 medical institutions completed the questionnaire. The vast majority (99.3%) of respondents reported experiencing symptoms of WRMSDs for at least one body region during the past 12 months. Work-related musculoskeletal pain or discomfort was most frequently reported for the neck (95.1%), right shoulder (84.1%), lower back (82.4%), right wrist/hand (81.0%), upper back (78.1%), right forearm/elbow (72.0%), and left shoulder (66.1%). Scanning hours per day, number of patients per day, and years of experience were positively associated with the occurrence and frequency of experiencing WRMSDs of some common and specific anatomical regions. Taking a regular rest break during the scanning working day was associated with a reduction of WRMSDs of the right shoulder and right wrist/hand. Adopting a sitting posture while performing scanning was associated with a reduction of WRMSDs, particularly for the lower back and the neck. Performing regular physical activity during leisure time was associated with a reduction of WRMSDs of the neck. The prevalence of WRMSDs among sonographers in China was extremely high. It is necessary and essential to reduce the number of scanning hours and patients per day, adopt a sitting posture while performing scanning, schedule regular rest breaks during the scanning working day, and encourage performance of regular physical activity during leisure time to alleviate this WRMSD issue experienced by sonographers.

Management of Intolerance to Casting the Upper Extremities in Claustrophobic Patients

PubMed Central

Nagura, Issei; Kanatani, Takako; Sumi, Masatoshi; Inui, Atsuyuki; Mifune, Yutaka; Kokubu, Takeshi; Kurosaka, Masahiro

2014-01-01

Introduction. Some patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities. We hypothesized their that intolerance with excessive anxiety to casts is due to claustrophobia triggered by cast immobilization. The aim of this study is to analyze the relevance of cast immobilization to the feeling of claustrophobia and discover how to handle them. Methods. There were nine patients who showed the caustrophobic symptoms with their casts. They were assesed whether they were aware of their claustrophobis themselves. Further we investigated the alternative immobilization to casts. Results. Seven out of nine cases that were aware of their claustrophobic tendencies either were given removable splints initially or had the casts converted to removable splints when they exhibited symptoms. The two patients who were unaware of their latent claustrophobic tendencies were identified when they showed similar claustrophobic symptoms to the previous patients soon after short arm cast application. We replaced the casts with removable splints. This resolved the issue in all cases. Conclusions. We should be aware of the claustrophobia if patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities, where removal splint is practical alternative to cast to continue the treatment successfully. PMID:25379544

Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models.

PubMed

Lee, Soo-Jeong; Lee, Joung Hee; Gillen, Marion; Krause, Niklas

2014-02-01

The aims of this study were to compare job demand-control (JDC) and effort-reward imbalance (ERI) models in examining the association of job stress with work-related musculoskeletal symptoms and to evaluate the utility of a combined model. This study analyzed cross-sectional survey data obtained from a nationwide random sample of 304 intensive-care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression. Both JDC and ERI variables had strong and statistically significant associations with work-related musculoskeletal symptoms. Effort-reward imbalance had stronger associations than job strain or iso-strain with musculoskeletal symptoms. Effort-reward imbalance alone showed similar or stronger associations with musculoskeletal symptoms compared to combined variables of the JDC and ERI models. The ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort-reward imbalance only. © 2013 Wiley Periodicals, Inc.

Orthopedic trauma surgery and hospital cost analysis in refugees; the effect of the Syrian civil War.

PubMed

Duramaz, Altuğ; Bilgili, Mustafa Gökhan; Bayram, Berhan; Ziroğlu, Nezih; Bayrak, Alkan; Avkan, Mustafa Cevdet

2017-05-01

The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees. Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost. The injuries were more frequently reported in lower extremities, upper extremities and axial skeleton, respectively. Blunt trauma was significantly higher in upper extremity injuries compared with the other types of injuries (p = 0.001). Fractures were most commonly reported in foot/ankle region and in males, hand/wrist fractures were significantly higher than that of the females. Plate fixation of upper extremity fractures and intramedullary nailing in lower extremity fractures were the most commonly preferred treatment modalities. The mean hospitalization period of patients was 5.6 days and the mean treatment cost was 3844 Turkish Liras (TL). In this study, it was shown that there was a statistically significant increase in the cost of health expenses in patients with fall from heights or gunshot wound, with fractures in axial skeleton or with the ISS score between 16 and 66. The cost rise was associated with worse prognosis, complications, intensive care treatments and prolonged hospitalization periods.

[Occupational myofibrosis - main aspects of clinics, diagnosis and treatment].

PubMed

Popov, A V; Ulanovskaya, E V

2013-01-01

Occupational chronic myofibrosis is a disease resulting from physical overstrain and functional overload of upper extremities and shoulder girdle and beeing the most prevalent occupational diseases related to the so-called "working hand". Myofibrosis occur among persons employed actually in all industries, building and agriculture and may develop as an isolated disease or combined with other occupational diseases of musculoskeletal and peripheral nervous systems. Today problems of diagnostics, especially at the early stage of the disease, and the development of knew methods of treatment are still topical.

Minimum important differences for the patient-specific functional scale, 4 region-specific outcome measures, and the numeric pain rating scale.

PubMed

Abbott, J Haxby; Schmitt, John

2014-08-01

Multicenter, prospective, longitudinal cohort study. To investigate the minimum important difference (MID) of the Patient-Specific Functional Scale (PSFS), 4 region-specific outcome measures, and the numeric pain rating scale (NPRS) across 3 levels of patient-perceived global rating of change in a clinical setting. The MID varies depending on the external anchor defining patient-perceived "importance." The MID for the PSFS has not been established across all body regions. One thousand seven hundred eight consecutive patients with musculoskeletal disorders were recruited from 5 physical therapy clinics. The PSFS, NPRS, and 4 region-specific outcome measures-the Oswestry Disability Index, Neck Disability Index, Upper Extremity Functional Index, and Lower Extremity Functional Scale-were assessed at the initial and final physical therapy visits. Global rating of change was assessed at the final visit. MID was calculated for the PSFS and NPRS (overall and for each body region), and for each region-specific outcome measure, across 3 levels of change defined by the global rating of change (small, medium, large change) using receiver operating characteristic curve methodology. The MID for the PSFS (on a scale from 0 to 10) ranged from 1.3 (small change) to 2.3 (medium change) to 2.7 (large change), and was relatively stable across body regions. MIDs for the NPRS (-1.5 to -3.5), Oswestry Disability Index (-12), Neck Disability Index (-14), Upper Extremity Functional Index (6 to 11), and Lower Extremity Functional Scale (9 to 16) are also reported. We reported the MID for small, medium, and large patient-perceived change on the PSFS, NPRS, Oswestry Disability Index, Neck Disability Index, Upper Extremity Functional Index, and Lower Extremity Functional Scale for use in clinical practice and research.

The effects of physical and psychosocial factors and ergonomic conditions on the prevalence of musculoskeletal disorders among dentists in Malaysia.

PubMed

Taib, Mohd Firdaus Mohd; Bahn, Sangwoo; Yun, Myung Hwan; Taib, Mohd Syukri Mohd

2017-01-01

Musculoskeletal disorders (MSDs) have been recognized as one of the main occupational health problems for dentists. Many studies have suggested that dentists experience work-related pain or discomfort in the neck, shoulder, and back, as well as in other parts of the body. This study aimed to examine the relationship between specific physical and psychosocial factors and/or ergonomic conditions on MSD symptoms among dentists in Malaysia. A group of 85 dentists was asked to complete a questionnaire to determine whether their complaints were related to physical and psychosocial factors and/or ergonomic conditions in their practices. Among the nine reviewed body areas, the shoulders were most often affected by symptoms of MSDs (92.7%). Moreover, MSDs of the neck and upper back were most likely to prevent these practitioners from engaging in normal activities (32.9%). In general, no significant differences were found in the prevalence of MSD symptoms in relation to gender, age, body mass index, years in practice, number of patients, and frequency of breaks. Our results were consistent with those reported in other studies that focused on MSD problems among dentists in other countries. To reduce the prevalence of MSDs, more attention should be paid to instituting ergonomically sensible approaches in the dental practice setting.

Risks of musculoskeletal disorders among betel quid preparers in Taiwan.

PubMed

Chang, Jer-Hao; Wu, Jyun-De; Chen, Chih-Yong; Sumd, Shih-Bin; Yin, Hsin-I; Hsu, Der-Jen

2014-04-01

Betel quid chewing is common in Taiwan. The work of betel quid preparers is characterized by long hours of static work, awkward working posture and highly repetitive hand/wrist motion. However, the musculoskeletal health of betel quid preparers receives very little attention. The Chinese version of the Standardized Nordic Musculoskeletal Questionnaire (NMQ) was administered, and electrogoniometers and electromyography were used in this cross-sectional study to characterize the hand/wrist motion of the subjects. Physical examinations on the thumbs and wrists of the subjects were conducted by means of Phalen's test and Finkelstein's test, respectively. Among the 225 participants, more than 95% attributed their musculoskeletal complaints to their work, and shoulder, neck, hand/wrist, and lower back discomfort were most frequently reported. More than 70% of the preparers did not seek medical treatment for their musculoskeletal problems. Based on the physical examination, 24% of the participants had suspected symptom of either carpal tunnel syndrome (CTS) or DeQuervain's tenosynovitis. The instrumental measurements indicated that betel quid preparation is characterized by extreme angle ranges and moderate repetition of wrist motion as well as low forceful exertion. This study concludes that betel quid preparers are a high risk group of developing musculoskeletal disorders (MSDs). Future studies by electrogoniometers and detailed physical examination on betel quid preparers are needed to determine the predisposing factors for CTS. Some intervention measures to prevent MSDs and to lessen psychological stress for this group of workers are strongly suggested. © 2014 Wiley Periodicals, Inc.

[Locomotive syndrome and frailty. Musculoskeletal ambulation disorder symptom complex and locomotive syndrome].

PubMed

Yamamoto, Noriaki

2012-04-01

Musculoskeletal ambulation disorder symptom complex is the new concept of musculoskeletal disorders with disability in walking and balance, which lead to the high risk of fall and lower activity in elderly. Locomotive syndrome is another concept to aware of healthy locomotive organ for early prevention of orthopedic disease.

Assessing the impact of waste picking on musculoskeletal disorders among waste pickers in Mumbai, India: a cross-sectional study

PubMed Central

Singh, Shrikant; Chokhandre, Praveen

2015-01-01

Objective To assess the prevalence of musculoskeletal disorders (MSDs) as well as the impact of the occupation of waste picking on complaints of MSDs among waste pickers. The study attempts to understand the risk factors for MSDs in various areas of the body. Design A cross-sectional household survey was conducted using a case-control design. The survey instrument for measuring musculoskeletal symptoms was adopted from a standardised Nordic questionnaire. The impact of the occupation of waste picking on MSDs was analysed using the propensity score matching (PSM) method. Participants The study population consisted of waste pickers (n=200) who had been working for at least a year and a control group (n=213) selected from among or living close to the same communities. Results The 12-month prevalence of MSDs was higher among waste pickers (79%) compared to controls (55%) particularly in the lower back (54–36%), knee (48–35%), upper back (40–21%) and shoulder (32–12%). Similar patterns were observed in the 12-month prevalence of MSDs which prevented normal activity inside and outside the home, particularly for the lower back (36–21%), shoulder (21–7%) and upper back (25–12%) for waste pickers and controls. Analysis of the impact of waste picking on complaints of MSDs suggests that the occupation of waste picking raises the risk of MSDs particularly in the shoulder, lower and upper back. Older age and longer duration of work are significant risk factors for MSDs. Conclusions The findings suggest a relatively higher prevalence of MSDs among waste pickers, particularly in the lower and upper back and shoulder, compared to controls. Preventive measures and treatment to minimise the burden of MSDs among waste pickers are strongly recommended. PMID:26408284

Dedicated Cone-Beam CT System for Extremity Imaging

PubMed Central

Al Muhit, Abdullah; Zbijewski, Wojciech; Thawait, Gaurav K.; Stayman, J. Webster; Packard, Nathan; Senn, Robert; Yang, Dong; Foos, David H.; Yorkston, John; Siewerdsen, Jeffrey H.

2014-01-01

Purpose To provide initial assessment of image quality and dose for a cone-beam computed tomographic (CT) scanner dedicated to extremity imaging. Materials and Methods A prototype cone-beam CT scanner has been developed for imaging the extremities, including the weight-bearing lower extremities. Initial technical assessment included evaluation of radiation dose measured as a function of kilovolt peak and tube output (in milliampere seconds), contrast resolution assessed in terms of the signal difference–to-noise ratio (SDNR), spatial resolution semiquantitatively assessed by using a line-pair module from a phantom, and qualitative evaluation of cadaver images for potential diagnostic value and image artifacts by an expert CT observer (musculoskeletal radiologist). Results The dose for a nominal scan protocol (80 kVp, 108 mAs) was 9 mGy (absolute dose measured at the center of a CT dose index phantom). SDNR was maximized with the 80-kVp scan technique, and contrast resolution was sufficient for visualization of muscle, fat, ligaments and/or tendons, cartilage joint space, and bone. Spatial resolution in the axial plane exceeded 15 line pairs per centimeter. Streaks associated with x-ray scatter (in thicker regions of the patient—eg, the knee), beam hardening (about cortical bone—eg, the femoral shaft), and cone-beam artifacts (at joint space surfaces oriented along the scanning plane—eg, the interphalangeal joints) presented a slight impediment to visualization. Cadaver images (elbow, hand, knee, and foot) demonstrated excellent visibility of bone detail and good soft-tissue visibility suitable to a broad spectrum of musculoskeletal indications. Conclusion A dedicated extremity cone-beam CT scanner capable of imaging upper and lower extremities (including weight-bearing examinations) provides sufficient image quality and favorable dose characteristics to warrant further evaluation for clinical use. © RSNA, 2013 Online supplemental material is available for this article. PMID:24475803

Pain-related and Psychological Symptoms in Adolescents With Musculoskeletal and Sleep Problems

PubMed Central

Wilson, Sue; Munafò, Marcus R.

2016-01-01

Objectives: Two-thirds of adolescents with chronic musculoskeletal pain report a concurrent sleep problem. Both musculoskeletal pain and sleep problems can have deleterious effects on physiological and psychological well-being. We explored the prevalence of sleep problems and musculoskeletal pain, using data on 3568 adolescents from the Avon Longitudinal Study of Children. Materials and Methods: A comprehensive battery of questionnaires was administered to derive clinical phenotypes of musculoskeletal pain. Adolescents with single symptoms were compared with those reporting both musculoskeletal pain and sleep problems. Linear and logistic regression analyses were used to compare groups on pain-related variables and psychological complaints. The association between sociodemographic variables and comorbid musculoskeletal pain and sleep problems was assessed using logistic regression. Results: Over half the sample was female (n=2076, 58.2%) and the majority of European ancestry (n=3174, 97.7%). Only 5.5% (n=196) of participants were identified as having a pain condition, while 21.2% (n=749) reported a significant sleep problem, and 2.8% (n=99) reported comorbid musculoskeletal pain and sleep problems. Adolescents with comorbid problems experienced greater pain intensity and pain-related anxiety. Other psychological complaints were also higher in those who experienced concurrent problems, including depression, fatigue, concentration, and overall severity of psychological symptoms. Discussion: Comorbid sleep and pain problems were associated with a higher incidence of pain-related and psychological symptoms. Sleep problems may therefore be an important modifiable risk factor for alleviating distress in adolescents with musculoskeletal pain. PMID:25974623

Effects of adolescent online gaming time and motives on depressive, musculoskeletal, and psychosomatic symptoms

PubMed Central

Nilsson, Kent W; Leppert, Jerzy; Åslund, Cecilia

2015-01-01

Aim. To investigate whether adolescent online gaming time and the additive effect of gaming motives were associated with depressive, musculoskeletal, and psychosomatic symptoms. The hypothesis was that adolescents who engage in online gaming with escape motives and increased online gaming time have higher probability for depressive, musculoskeletal, and psychosomatic symptoms compared to adolescents with other online gaming motives and/or less online gaming time. Method. An anonymous and voluntary questionnaire was completed during class hours by 7,757 Swedish adolescents aged 13–18 years. The questionnaire included demographic background, gaming habits, and depressive, musculoskeletal, and psychosomatic symptoms. Results. It was found that increased online gaming time during weekdays increased the probability of having depressive, musculoskeletal, and psychosomatic symptoms. However, these relations with time spent gaming were further explained by online gaming motives. Weekday online gaming for more than five hours a day, in combination with escape motives, was associated with an increased probability of depressive symptoms (odds ratio (OR) 4.614, 95% CI 3.230–6.590), musculoskeletal symptoms (OR 2.494, 95% CI 1.598–3.892), and psychosomatic symptoms (OR 4.437, 95% CI 2.966–6.637). The probability of ill health decreased when gaming was for fun or had social motives. Conclusion. Excessive gaming time and escape motives were found to be associated with increased probability of ill health among adolescents. Gaming motives may identify gamers in need of support to reduce unhealthy gaming behaviour as well as identify individuals at risk for ill health. PMID:26072677

Musculoskeletal disorders among construction apprentices in Hungary.

PubMed

Rosecrance, J; Pórszász, J; Cook, T; Fekecs, E; Karácsony, T; Merlino, L; Anton, D

2001-11-01

The purpose of this study was to determine the prevalence of occupationally related musculoskeletal disorder (MSD) symptoms and carpal tunnel syndrome (CTS) among construction apprentices in Hungary. Symptoms of occupational MSDs and the job factors contributing to the symptoms were determined through an administered symptom and job factors survey. The prevalence of CTS was based on a case definition that included hand symptoms and nerve conduction studies of the median nerve across the carpal tunnel. The participation rate was 96% among the 201 eligible construction apprentices. More than 50% of the apprentices reported occupationally related musculoskeletal symptoms in the previous 12 months. Job tasks that required awkward postures and working in a static position were the two factors that contributed most to MSD symptoms. No cases of CTS were found in this sample of apprentices. Although disorders of the musculoskeletal system are more prevalent among experienced construction workers, this study indicated that symptoms of MSDs are present among young construction workers. Assessing the magnitude and nature of occupational related MSDs is the first step in promoting a healthier, safer, and more efficient workforce.

The comparison of frequency of the upper limb musculoskeletal disorders among patients with diabetes type II with normal cases.

PubMed

Kermani, Zahra Haeri; Bazzaz, Seyed Mojtaba Mousavi; Farahmand, Seyed Kazem; Raoof, Ali Akbar

2017-11-01

Musculoskeletal disease, that is recognized in diabetes and diabetes mellitus (DM) has shown a higher prevalence of chronic musculoskeletal complications. This study aimed at assessing the frequency of upper limb musculoskeletal disorders among patients with diabetes type II with normal cases in Mashhad, Iran. A cross-section of 100 patients with upper limb musculoskeletal disorders were enrolled in this study. The patients were examined by a unique physician considering carpal tunnel syndrome disorder, trigger finger, adhesive capsulitis, and Dupuytren's contracture at Ghaem hospital, Mashhad, Iran in 2015. All collected data were recorded by using SPSS version 21 and were analyzed through independent-samples t-test for comparing changes, and Chi-square. In this study, the mean age was 51.7±8.7 years old. Gender frequency was 114 (57%) male, and 86 (43%) female. There was no significant difference between groups in cases of gender frequency and mean of age (p>0.05). In evaluation of association between the two groups, there was significant difference for adhesive capsulitis, (p=0.04). Chi-square test showed significant association for age and adhesive capsulitis between the two groups, (p=0.040); but no other diabetes-related disorders, (p<0.05). The results of this study showed that in patients with diabetes mellitus and musculoskeletal complications such as upper limb musculoskeletal abnormalities, it will lead to an increase in skeletal muscle effects in DM patients. It is recommended that musculoskeletal examination is done periodically in DM patients for identification of these disorders and necessary actions are carried out for prevention of the disorders as soon as possible.

Injury Surveillance Among NASA Astronauts Using the Barell Injury Diagnosis Matrix

NASA Technical Reports Server (NTRS)

Murray, J. D.; Laughlin, M. S.; Eudy, D. L.; Wear, M. L.; VanBaalen, M. G.

2014-01-01

Astronauts perform physically demanding tasks and risk incurring musculoskeletal injuries during both groundbased training and missions. Increased injury rates throughout the history of the U.S. space program have been attributed to numerous factors, including an aging astronaut corps, increased Weightless Environment Training Facility (WETF) and Neutral Buoyancy Laboratory (NBL) training to construct the International Space Station, and improved clinical operations that promote injury prevention and reporting. With NASA program changes through the years (including retirement of the Shuttle program) and an improved training environment (including a new astronaut gym), there is no surveillance program to systematically track injury rates. A limited number of research projects have been conducted over the past 20 years to evaluate musculoskeletal injuries: (1) to evaluate orthopedic injuries from 1987 to 1995, (2) to describe upper extremity injuries, (3) to evaluate EVA spacesuit training related injuries, and (4) to evaluate in-flight musculoskeletal injuries. Nevertheless, there has been no consistently performed comprehensive assessment of musculoskeletal injuries among astronauts. The Barell Injury Diagnosis Matrix was introduced at the 2001 meeting of the International Collaborative Effort (ICE) on Injury Statistics. The Matrix proposes a standardized method of classifying body region by nature of injury. Diagnoses are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system. The purpose of this study is to assess the usefulness and complexity of the Barell Injury Diagnosis Matrix to classify and track musculoskeletal injuries among NASA astronauts.

Hypercalcemia in a bodybuilder with cosmetic silicone injections.

PubMed

Hamadeh, Majdi; Fares, Jawad; Maatouk, Khalil; Darwish, Mohamad

2018-04-13

Granulomatous hypercalcemia due to silicone injections is a rare disease with scarce literature. We present a case of a 35-year-old Caucasian male bodybuilder with multiple silicone injections in his upper extremities who developed hypercalcemia and urinary symptoms. He necessitated two sessions of dialysis. A biopsy of the upper arm showed granulomatous tissue. Corticosteroids were administered to relieve symptoms and reverse laboratory abnormalities. Silicone-induced hypercalcemia should be on high alert because of the increasing trend of body contour enhancements with injections, implants and fillers.

Severe musculoskeletal time-loss injuries and symptoms of common mental disorders in professional soccer: a longitudinal analysis of 12-month follow-up data.

PubMed

Kiliç, Ö; Aoki, H; Goedhart, E; Hägglund, M; Kerkhoffs, G M M J; Kuijer, P P F M; Waldén, M; Gouttebarge, V

2018-03-01

Psychological factors have shown to be predictors of injury in professional football. However, it seems that this is a two-way relationship, as severe musculoskeletal time-loss injuries have shown to be associated with the onset of symptoms of common mental disorders (CMD). There is no longitudinal study performed exploring this interaction between symptoms of CMD and injuries. The purpose of this study was to explore the interaction between severe musculoskeletal time-loss injuries and symptoms of CMD in professional football players over a 12-month period. Players were recruited by their national players' unions in five European countries. Symptoms of CMD included in the study were related to distress, anxiety/depression, sleep disturbance and adverse alcohol use. A total of 384 professional football players were enrolled in the study, of whom 262 (68%) completed the 12-month follow-up period. The mean age of the participants at baseline was 27 ± 5 years, and they had played professional football for 8 ± 5 years on average. Symptoms of CMD at baseline were not associated with the onset of severe musculoskeletal time-loss injuries during the follow-up period with relative risks (and 95% CI) ranging from 0.6 (0.3-1.0) to 1.0 (0.5-2.2). In contrast, severe musculoskeletal time-loss injuries reported at baseline were associated with the onset of symptoms of CMD during the follow-up period with relative risks ranging from 1.8 (0.8-3.7) to 6.9 (4.0-11.9). No relationship was found between symptoms of CMD and the onset of severe musculoskeletal time-loss injuries. However, professional football players who suffered from severe musculoskeletal time-loss injuries are likely to develop subsequent symptoms of CMD. This study emphasizes the need for an interdisciplinary medical approach, which not only focuses on the physical but also on the mental health of professional football players. An early identification of players at risk of symptoms of CMD, such as those suffering from severe musculoskeletal injuries, creates the opportunity for an interdisciplinary clinical medical team to treat the players timely and adequately. Prospective cohort study, Level II.

Musculoskeletal Complaints in Transverse Upper Limb Reduction Deficiency and Amputation in The Netherlands: Prevalence, Predictors, and Effect on Health.

PubMed

Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

2016-07-01

(1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals with upper limb absence in The Netherlands, (2) to assess the health status of individuals with upper limb absence in general and in relation to the presence of MSCs, and (3) to explore the predictors of development of MSCs and MSC-related disability in this population. Cross-sectional study: national survey. Twelve rehabilitation centers and orthopedic workshops. Individuals (n=263; mean age, 50.7±16.7y; 60% men) ≥18 years old, with transverse upper limb reduction deficiency (42%) or amputation (58%) at or proximal to the carpal level (response, 45%) and 108 individuals without upper limb reduction deficiency or amputation (n=108; mean age, 50.6±15.7y; 65% men) (N=371). Not applicable. Point and year prevalence of MSCs, MSC-related disability (Pain Disability Index), and general health perception and mental health (RAND-36 subscales). Point and year prevalence of MSCs were almost twice as high in individuals with upper limb absence (57% and 65%, respectively) compared with individuals without upper limb absence (27% and 34%, respectively) and were most often located in the nonaffected limb and upper back/neck. MSCs were associated with decreased general health perception and mental health and higher perceived upper extremity work demands. Prosthesis use was not related to presence of MSCs. Clinically relevant predictors of MSCs were middle age, being divorced/widowed, and lower mental health. Individuals with upper limb absence experienced more MSC-related disability than individuals without upper limb absence. Higher age, more pain, lower general and mental health, and not using a prosthesis were related to higher disability. Presence of MSCs is a frequent problem in individuals with upper limb absence and is associated with decreased general and mental health. Mental health and physical work demands should be taken into account when assessing such a patient. Clinicians should note that MSC-related disability increases with age. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rugby injuries.

PubMed

McIntosh, Andrew S

2005-01-01

The purpose of this chapter is to review critically the existing studies on the epidemiology of pediatric rugby injuries and discuss suggestions for injury prevention and further research. Data were sourced from the sports medicine and science literature mainly since 1990, and from a prospective injury surveillance project in rugby undertaken by the University of New South Wales (UNSW) in Sydney during 2002. Literature searches were performed using Medline and SportsDiscus. Reported injury rates were between 7 and 18 injuries per 1,000 hours played, with the rate of injuries resulting in loss of playing or training time measured at 6.5-10.6 per 1,000 hours played. Injury rates increased with age and level of qualification. Head injury and concussion accounted for 10-40% of all injuries. In the UNSW study, concussion accounted for 25% of injuries resulting in loss of playing or training time in the under 13 year age group. Upper and lower extremity injuries were equally apportioned, with musculoskeletal injuries being the main type of injury. Fractures were observed in the upper extremity and ankle, and joint/ligament injuries affected the shoulder, knee and ankle. The tackle was associated with around 50% of all injuries. The scrum produced fewer injuries, but is historically associated with spinal cord injury. Rugby is a contact sport with injury risks related to physical contact, primarily in the tackle. Most injuries affect the musculoskeletal system, with the exception of concussion. Spinal cord injury is rare, but catastrophic. Research is required to understand better injury risks and to reduce the incidence of shoulder, knee and ankle joint injuries, concussion and spinal injury.

Leisure-time sport and overuse injuries of extremities in children age 6-13, a 2.5 years prospective cohort study: the CHAMPS-study DK.

PubMed

Chéron, Charlène; Leboeuf-Yde, Charlotte; Le Scanff, Christine; Jespersen, Eva; Rexen, Christina Trifonov; Franz, Claudia; Wedderkopp, Niels

2017-01-13

It is not known which sports are most likely to cause overuse injuries of the extremities in children. In this study, we report on the incidence of overuse injuries of the upper and lower extremities in children who participate in various leisure-time sports and relate this to the frequency of sport sessions. Natural experiment including a prospective cohort study. 10 state schools in 1 Danish municipality: Svendborg. 1270 children aged 6-13 years participating in the Childhood Health, Activity, and Motor Performance School Study Denmark. Over 2.5 years, parents answered weekly SMS-track messages (a) on type and frequency of leisure-time sports undertaken by their child, and (b) reporting if their child had experienced any musculoskeletal pain. Children with reported pain were examined by a clinician and diagnosed as having an overuse injury of an extremity or not. The incidence of diagnosed overuse injury was calculated for each of the 9 most common sports in relation to 5-week periods. Incidence by frequency of sessions was calculated, and multivariable analysis was performed taking into account age, sex and frequency of physical education classes at school. Incidence of overuse injuries of the lower extremity ranged from 0.2 to 3.3 for the 9 sports, but was near 0 for overuse injuries of the upper extremities. There was no obvious dose-response. The multivariate analysis showed soccer and handball to be the sports most likely to result in an overuse injury. Among a general population of schoolchildren, overuse injuries of the lower extremities were not common and overuse injuries of the upper extremities were rare. Organised leisure-time sport, as practised in Denmark, can be considered a safe activity for children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Leisure-time sport and overuse injuries of extremities in children age 6–13, a 2.5 years prospective cohort study: the CHAMPS-study DK

PubMed Central

Chéron, Charlène; Leboeuf-Yde, Charlotte; Le Scanff, Christine; Jespersen, Eva; Rexen, Christina Trifonov; Franz, Claudia; Wedderkopp, Niels

2017-01-01

Objectives It is not known which sports are most likely to cause overuse injuries of the extremities in children. In this study, we report on the incidence of overuse injuries of the upper and lower extremities in children who participate in various leisure-time sports and relate this to the frequency of sport sessions. Design Natural experiment including a prospective cohort study. Setting 10 state schools in 1 Danish municipality: Svendborg. Participants 1270 children aged 6–13 years participating in the Childhood Health, Activity, and Motor Performance School Study Denmark. Outcomes measures Over 2.5 years, parents answered weekly SMS-track messages (a) on type and frequency of leisure-time sports undertaken by their child, and (b) reporting if their child had experienced any musculoskeletal pain. Children with reported pain were examined by a clinician and diagnosed as having an overuse injury of an extremity or not. The incidence of diagnosed overuse injury was calculated for each of the 9 most common sports in relation to 5-week periods. Incidence by frequency of sessions was calculated, and multivariable analysis was performed taking into account age, sex and frequency of physical education classes at school. Results Incidence of overuse injuries of the lower extremity ranged from 0.2 to 3.3 for the 9 sports, but was near 0 for overuse injuries of the upper extremities. There was no obvious dose–response. The multivariate analysis showed soccer and handball to be the sports most likely to result in an overuse injury. Conclusions Among a general population of schoolchildren, overuse injuries of the lower extremities were not common and overuse injuries of the upper extremities were rare. Organised leisure-time sport, as practised in Denmark, can be considered a safe activity for children. PMID:28087543

The Fear-Avoidance Components Scale (FACS): Responsiveness to Functional Restoration Treatment in a Chronic Musculoskeletal Pain Disorder (CMPD) Population.

PubMed

Neblett, Randy; Mayer, Tom G; Williams, Mark J; Asih, Sali; Cuesta-Vargas, Antonio I; Hartzell, Meredith M; Gatchel, Robert J

2017-12-01

To assess the clinical validity and factor structure of the Fear-Avoidance Components Scale (FACS), a new fear-avoidance measure. In this study, 426 chronic musculoskeletal pain disorder patients were admitted to a Functional Restoration Program (FRP). They were categorized into 5 FACS severity levels, from subclinical to extreme, at admission, and again at discharge. Associations with objective lifting performance and other patient-reported psychosocial measures were determined at admission and discharge, and objective work outcomes for this predominantly disabled cohort, were assessed 1 year later. Those patients in the severe and extreme FACS severity groups at admission were more likely to "drop out" of treatment than those in the lower severity groups (P=0.05). At both admission and discharge, the FACS severity groups were highly and inversely correlated with objective lifting performance and patient-reported fear-avoidance-related psychosocial variables, including kinesiophobia, pain intensity, depressive symptoms, perceived disability, perceived injustice, and insomnia (Ps<0.001). All variables showed improvement at FRP discharge. Patients in the extreme FACS severity group at discharge were less likely to return to, or retain, work 1 year later (P≤0.02). A factor analysis identified a 2-factor solution. Strong associations were found among FACS scores and other patient-reported psychosocial and objective lifting performance variables at both admission and discharge. High discharge-FACS scores were associated with worse work outcomes 1 year after discharge. The FACS seems to be a valid and clinically useful measure for predicting attendance, physical performance, distress, and relevant work outcomes in FRP treatment of chronic musculoskeletal pain disorder patients.

The ergonomics approach for thin film transistor-liquid crystal display manufacturing process.

PubMed

Lu, Chih-Wei; Yao, Chia-Chun; Kuo, Chein-Wen

2012-01-01

The thin film transistor-liquid crystal display (TFT-LCD) has been used all over the world. Although the manufacture process of TFT-LCD was highly automated, employees are hired to do manual job in module assembly process. The operators may have high risk of musculoskeletal disorders because of the long work hours and the repetitive activities in an unfitted work station. The tools of this study were questionnaire, checklist and to evaluate the work place design. The result shows that the participants reported high musculoskeletal disorder symptoms in shoulder (59.8%), neck (49.5%), wrist (39.5%), and upper back (30.6%). And, to reduce the ergonomic risk factors, revising the height of the work benches, chairs and redesigning the truck to decrease the chance of unsuitable positions were recommended and to reduce other ergonomics hazards and seta good human machine interface and appropriate job design.

Lower extremity EMG-driven modeling of walking with automated adjustment of musculoskeletal geometry

PubMed Central

Meyer, Andrew J.; Patten, Carolynn

2017-01-01

Neuromusculoskeletal disorders affecting walking ability are often difficult to manage, in part due to limited understanding of how a patient’s lower extremity muscle excitations contribute to the patient’s lower extremity joint moments. To assist in the study of these disorders, researchers have developed electromyography (EMG) driven neuromusculoskeletal models utilizing scaled generic musculoskeletal geometry. While these models can predict individual muscle contributions to lower extremity joint moments during walking, the accuracy of the predictions can be hindered by errors in the scaled geometry. This study presents a novel EMG-driven modeling method that automatically adjusts surrogate representations of the patient’s musculoskeletal geometry to improve prediction of lower extremity joint moments during walking. In addition to commonly adjusted neuromusculoskeletal model parameters, the proposed method adjusts model parameters defining muscle-tendon lengths, velocities, and moment arms. We evaluated our EMG-driven modeling method using data collected from a high-functioning hemiparetic subject walking on an instrumented treadmill at speeds ranging from 0.4 to 0.8 m/s. EMG-driven model parameter values were calibrated to match inverse dynamic moments for five degrees of freedom in each leg while keeping musculoskeletal geometry close to that of an initial scaled musculoskeletal model. We found that our EMG-driven modeling method incorporating automated adjustment of musculoskeletal geometry predicted net joint moments during walking more accurately than did the same method without geometric adjustments. Geometric adjustments improved moment prediction errors by 25% on average and up to 52%, with the largest improvements occurring at the hip. Predicted adjustments to musculoskeletal geometry were comparable to errors reported in the literature between scaled generic geometric models and measurements made from imaging data. Our results demonstrate that with appropriate experimental data, joint moment predictions for walking generated by an EMG-driven model can be improved significantly when automated adjustment of musculoskeletal geometry is included in the model calibration process. PMID:28700708

Factors associated with self-estimated work ability and musculoskeletal symptoms among male and female workers in cooled food-processing facilities.

PubMed

Sormunen, Erja; Remes, Jouko; Hassi, Juhani; Pienimäki, Tuomo; Rintamäki, Hannu

2009-07-01

This questionnaire study evaluates how work ability and musculoskeletal symptoms associate with physical work factors and individual characteristics of the workers in cooled food-processing facilities. A total of 1,117 workers (response rate 85%) responded to the study. Poor work ability was significantly associated with longer work duration, experience of draught at the workplace, absence from work due to health reasons, and physical inactivity during free time. The amount of local cooling experienced was significantly associated with the risk for musculoskeletal symptoms in the neck-shoulder region, shoulders, wrists and lower back. Additionally, female gender, longer work duration and poor work ability were associated with the increased prevalence of the symptoms. The prevalence of musculoskeletal symptoms was significantly higher among older employees (40 to 64 yr) than among younger employees (18 to 39 yr) for all regions except wrists. Cold discomfort and unpleasant sensations due to the physical factors of work were significantly more common among females than males. The results showed that, in addition to individual characteristics of workers, factors related to work in a cool environment (experience of draught and cooling and long exposure to cold) are associated with poor work ability and musculoskeletal symptoms.

Musculoskeletal symptoms in workers of a Telecom Company.

PubMed

Antunes, Evelise Dias; de Araújo, Célia Regina Alves; Abage, Zilda

2012-01-01

Millions of people work with computers every day. Human work provides a means of comfort and ease to perform the tasks, favoring incorrect postures. Among the employees of a telecom company, it appears that all make use of computer, remaining in a seated position leading in musculoskeletal symptoms. This is a quantitative study, conducted in a telecom company in the city of Curitiba. Were interviewed 27 analysts who work in engineering department, who agreed to participate and receive guidelines regarding sitting posture. This study, consisted of a structured questionnaire and the Nordic Musculoskeletal Questionnaire with musculoskeletal symptoms indicators. After answering the questionnaire, the subjects were guided through the folder on correct posture and positioning front the computer. Of employees 74% were male, and 100% of the employees are the computer's user, remaining in the sitting posture during working day. Concerning the break time, 74% reported that they frequently do it. Been the average working day is 8 hours. Regarding the frequency of musculoskeletal symptoms, 70% of employees reported some symptoms during the last 12 months but only one came to be sick leave. It is necessary to an analysis of the work situation, evaluating and correcting inadequacies of securities and the risks inherent in function, making prevention.

Perceived competence in computer use as a moderator of musculoskeletal strain in VDU work: an ergonomics intervention case.

PubMed

Tuomivaara, S; Ketola, R; Huuhtanen, P; Toivonen, R

2008-02-01

Musculoskeletal strain and other symptoms are common in visual display unit (VDU) work. Psychosocial factors are closely related to the outcome and experience of musculoskeletal strain. The user-computer relationship from the viewpoint of the quality of perceived competence in computer use was assessed as a psychosocial stress indicator. It was assumed that the perceived competence in computer use moderates the experience of musculoskeletal strain and the success of the ergonomics intervention. The participants (n = 124, female 58%, male 42%) worked with VDU for more than 4 h per week. They took part in an ergonomics intervention and were allocated into three groups: intensive; education; and reference group. Musculoskeletal strain, the level of ergonomics of the workstation assessed by the experts in ergonomics and amount of VDU work were estimated at the baseline and at the 10-month follow-up. Age, gender and the perceived competence in computer use were assessed at the baseline. The perceived competence in computer use predicted strain in the upper and the lower part of the body at the follow-up. The interaction effect shows that the intensive ergonomics intervention procedure was the most effective among participants with high perceived competence. The interpretation of the results was that an anxiety-provoking and stressful user-computer relationship prevented the participants from being motivated and from learning in the ergonomics intervention. In the intervention it is important to increase the computer competence along with the improvements of physical workstation and work organization.

Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden – an investigation of 2000 randomly selected patient records

PubMed Central

Fahlström, Martin; Djupsjöbacka, Mats

2016-01-01

Abstract Rationale, aims and objectives The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Methods Patient records (2000) for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3‐year period was reviewed retrospectively. For all patient records' background data, cause to the visit and diagnosis were registered. For visits due to MSD, type and location of symptoms and actions to resolve the patients problems were registered. Data was analysed using cross tabulation, multidimensional chi‐squared. Results The prevalence of MSD was high; almost 60% of all patients were seeking care due to MSD. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age groups. The patients got a variety of different diagnoses, and between 13 and 35% of the patients did not receive a MSD diagnose despite having MSD symptoms. There was a great variation in how the cases were handled. Conclusions The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. PMID:27538347

Prevalence, diagnostics and management of musculoskeletal disorders in primary health care in Sweden - an investigation of 2000 randomly selected patient records.

PubMed

Wiitavaara, Birgitta; Fahlström, Martin; Djupsjöbacka, Mats

2017-04-01

The aims of this study is to investigate the prevalence of patients seeking care due to different musculoskeletal disorders (MSDs) at primary health care centres (PHCs), to chart different factors such as symptoms, diagnosis and actions prescribed for patients that visited the PHCs due to MSD and to make comparisons regarding differences due to gender, age and rural or urban PHC. Patient records (2000) for patients in working age were randomly selected equally distributed on one rural and one urban PHC. A 3-year period was reviewed retrospectively. For all patient records' background data, cause to the visit and diagnosis were registered. For visits due to MSD, type and location of symptoms and actions to resolve the patients problems were registered. Data was analysed using cross tabulation, multidimensional chi-squared. The prevalence of MSD was high; almost 60% of all patients were seeking care due to MSD. Upper and lower limb problems were most common. Symptoms were most prevalent in the young and middle age groups. The patients got a variety of different diagnoses, and between 13 and 35% of the patients did not receive a MSD diagnose despite having MSD symptoms. There was a great variation in how the cases were handled. The present study points out some weaknesses regarding diagnostics and management of MSD in primary care. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Should studies of risk factors for musculoskeletal disorders be stratified by gender? Lessons from the 1998 Québec Health and Social Survey.

PubMed

Messing, Karen; Stock, Susan R; Tissot, France

2009-03-01

Several studies have reported male-female differences in the prevalence of symptoms of work-related musculoskeletal disorders (MSD), some arising from workplace exposure differences. The objective of this paper was to compare two strategies analyzing a single dataset for the relationships between risk factors and MSD in a population-based sample with a wide range of exposures. The 1998 Québec Health and Social Survey surveyed 11 735 respondents in paid work and reported "significant" musculoskeletal pain in 11 body regions during the previous 12 months and a range of personal, physical, and psychosocial risk factors. Five studies concerning risk factors for four musculoskeletal outcomes were carried out on these data. Each included analyses with multiple logistic regression (MLR) performed separately for women, men, and the total study population. The results from these gender-stratified and unstratified analyses were compared. In the unstratified MLR models, gender was significantly associated with musculoskeletal pain in the neck and lower extremities, but not with low-back pain. The gender-stratified MLR models identified significant associations between each specific musculoskeletal outcome and a variety of personal characteristics and physical and psychosocial workplace exposures for each gender. Most of the associations, if present for one gender, were also found in the total population. But several risk factors present for only one gender could be detected only in a stratified analysis, whereas the unstratified analysis added little information. Stratifying analyses by gender is necessary if a full range of associations between exposures and MSD is to be detected and understood.

[The effect of different types of sports and athletes' age on the pathological changes of the musculoskeletal system].

PubMed

Achkasov, E E; Puzin, S N; Litvinenko, A S; Kurshev, V V; Bezuglov, E N

2014-01-01

Our aim was to determine the most common musculoskeletal diseases, depending on the type of sports and athletes' age. The results of examination of 976 athletes aged from 16 to 42 years (average age - 28,9±2,3) with musculoskeletal diseases were analyzed. Medical diagnostic procedures included clinical, laboratory, instrumental (radiography, magnetic resonance imaging, ultrasound) investigations and functional testing (goniometry, manual muscle testing). Majority of patients were diagnosed to have diseases of the knee (17.9%) and ankle joints (11.3%), the heel bone (12.9%), Achilles tendon (10.2%), post-traumatic musculoskeletal diseases (16.2%), degenerative-dystrophic diseases of the spine (12.8%). In the young age group (16 to 20 years) post-traumatic disorders were most common. In the middle-age group (21 to 30 years) along with post-traumatic disorders diseases of the knee frequently occurred. For athletes over 30 years old, along with diseases of the knee spinal diseases were found to occur 2-3 times more frequently in comparison with other age groups. Injuries which are more common for different types of sports were identified: acute traumas - competitive sports, diseases of the calcaneus - sports with running and jumping (athletics, volleyball, soccer), disease of ankle joints - sport with sharp change in movement direction (hockey, figure skating), disease of the knee - sports with high load of the knee joint (figure skating, gymnastics, volleyball, diseases of bones and joints of the upper extremity - tennis, disease of spine - weightlifting. pathological changes in the musculoskeletal system depend on the type of sports and the age of athletes. The combination of age and risk factors associated with type of sport increases the possibility of development of these diseases of the musculoskeletal system.

Workplace changes associated with a reduction in musculoskeletal symptoms in office workers.

PubMed

Nelson, N A; Silverstein, B A

1998-06-01

The purpose of this study was to identify factors associated with reductions observed in musculoskeletal symptoms when office workers were moved to a new building. A questionnaire including items regarding symptoms and aspects of the work environment was administered to 577 office workers before and after they were moved from nine buildings to a single new facility in 1992. Employees working in two reference buildings, where they remained throughout the study period, were also surveyed. Two musculoskeletal outcomes, hand/arm and neck/shoulder/back, were selected for study. In matched multivariate analyses, the reduction in hand/arm symptoms from 1992 to 1993 was associated with improved satisfaction with the physical workstation (odds ratio [OR] = 2.0); the reduction in neck/shoulder/back symptoms was associated with improved chair comfort (OR = 1.8), fewer housekeeping responsibilities (OR = 3.6), female gender (OR = 1.8), and low pay range (OR = 1.7). Longitudinal results suggested that changes in workstations resulted in decreased symptoms. Results of this investigation might be used to develop workplace changes that result in reductions of musculoskeletal disorders.

Risk factors associated with musculoskeletal symptoms in Korean dental practitioners.

PubMed

Cho, KiHun; Cho, Hwi-Young; Han, Gyeong-Soon

2016-01-01

[Purpose] The purpose of this study was to investigate the association between psychosocial stress, occupational stress, and musculoskeletal symptoms in Korean dental practitioners. [Subjects and Methods] Self-reported questionnaires were distributed to 401 dental practitioners in Korea. To assess the risk factors related to musculoskeletal disorders, the Nordic Musculoskeletal Questionnaire, the Korean Occupational Stress Scale, and Psychosocial Well-Being Index Short Form were used. General and work-related characteristics of the subjects consisted of seven items, including age, career, height, weight, working days/week, working hours/day, and physical strain levels. [Results] In this study, 86.8% of the practitioners experienced musculoskeletal symptoms (shoulders, 72.8%; neck, 69.3%; waist, 68.3%; wrist, 58.4%; back, 44.1%; ankle, 38.7%; knee, 36.9%; hip, 20.4%; and elbows, 9.2%). Moreover, psychosocial and occupational stress can affect the occurrence of musculoskeletal disorders. In particular, we found that psychosocial stress has significant influence on the occurrence of musculoskeletal disorders. [Conclusion] To increase the quality of life and provide high-quality medical service for dental practitioners, risk factors for musculoskeletal disorders must be managed. Accordingly, dental practitioners must maintain good posture, get an appropriate amount of rest, and perform regular stretching exercise to reduce psychological stress and improve the work environment.

The relationship between smartphone use and subjective musculoskeletal symptoms and university students

PubMed Central

Kim, Hyo-Jeong; Kim, Jin-Seop

2015-01-01

[Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage. PMID:25931684

Clinical effect of acupuncture on cervical spondylotic radiculopathy: results of a case series.

PubMed

Nakajima, Miwa; Inoue, Motohiro; Itoi, Megumi; Kitakoji, Hiroshi

2013-12-01

To observe the effectiveness of acupuncture applied to the cervical region of patients with upper extremity radicular symptoms due to cervical spondylotic radiculopathy (CSR). 15 subjects diagnosed with CSR and with upper extremity pain and/or paraesthesiae for 13.1±18.0 months were selected. The 15 patients had 16 affected limbs and scored a total of 17 symptom scores of pain and/or paraesthesiae. All patients were treated with acupuncture once a week for 4 weeks at up to 10 sites in the cervical paraspinal region centred on the affected area. The severity of the symptoms was recorded using a visual analogue scale (VAS) and functional evaluation was conducted using a Neck Disability Index (NDI). A significant reduction over time was seen for both mean VAS (p<0.0001) and NDI (p<0.0001). Changes were still significant at 4-week follow-up. A 50% reduction in symptoms was scored for 15 of the 17 symptoms scored. Favourable results were seen in nearly 90% of cases. These results show that acupuncture treatment to the cervical region may be effective as a conservative therapy for treating CSR.

Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

PubMed

Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

2015-09-01

This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Childhood-onset eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome): a contemporary single-center cohort.

PubMed

Gendelman, Samantha; Zeft, Andrew; Spalding, Steven J

2013-06-01

To date only 38 cases of childhood-onset eosinophilic granulomatosis with polyangiitis (cEGPA; formerly Churg-Strauss syndrome) have been reported. Additional patients with cEGPA could enhance the understanding of this rare and life-threatening condition. Our objectives were (1) to determine the frequency of specific organ system involvement; (2) to examine initial therapeutic regimen; and (3) to document disease and therapy-related morbidity in a contemporary cohort of patients with cEGPA. Retrospective review of patients evaluated at the Cleveland Clinic between 2003 and 2011 who met either American College of Rheumatology or Lanham criteria for EGPA and whose age was < 18 years at symptom onset. Nine patients (8 female; 7 white) were identified. Median age at onset of rhinitis/asthma symptom was 13 years and median age at diagnosis of cEGPA was 15 years. All patients demonstrated eosinophilia, upper airway disease (allergic rhinitis, chronic sinusitis, and/or nasal polyps), and pulmonary involvement. Other frequently involved organ systems included musculoskeletal (67%), gastrointestinal (67%), cutaneous (67%), neurologic (56%), and cardiac (44%). Antineutrophil cytoplasmic antibody (ANCA) serologies were negative in all patients. The medications used most frequently for initial therapy included oral (44%) or intravenous corticosteroids (56%) and azathioprine (67%). Disease or therapeutic complications occurred in half of the cohort and included heart failure, stroke, and sequela from longterm, high-dose steroids. Eosinophilia, in combination with upper airway, pulmonary, musculoskeletal, neurologic, and cardiac manifestations, is frequently observed in cEGPA. ANCA titers are often negative. Steroids are the mainstay of initial therapy but steroid-related side effects occur regularly.

Environmental and organizational factors associated with elbow/forearm and hand/wrist disorder among sewing machine operators of garment industry in Ethiopia.

PubMed

Kebede Deyyas, Wakjira; Tafese, Ararso

2014-01-01

Occupational health problems related to upper limp musculoskeletal disorders were the major issue among sewing machine operators of garment industries in Ethiopia. The aim of this study was to assess the prevalence and associated risk factors of work related elbow and wrist musculoskeletal disorders among sewing machine operators of garment industries in Galan City, Oromia Regional State. A cross-sectional study was conducted from April 1 to 30, 2012. A total of 422 study subjects were included in this study. Standard Nordic Musculoskeletal Questionnaire was used to collect detailed information on musculoskeletal symptom, sociodemographic data, and factors associated with the problems through face to face interview. From a total of 422 sewing machine operators included in the study 370 (87.7%) were females and 306 (72.5%) were in the age group of <30 years. The prevalence of self-reported work related elbow and wrist musculoskeletal disorders was 40% and 37.7%, respectively. In multivariate analysis, those who had >16 years of service were about five times more likely to develop elbow and wrist musculoskeletal disorders than those who had short (1-5 years) year of services [AOR = 4.7, 95% CI: 1.55-13.02], physical activities [AOR = 5.02, 95% CI: 1.57-16.00], and methods of payment [AOR = 2.01, 95% CI: 1.23-3.28], factors significantly associated with this disorders. Work related elbow and wrist musculoskeletal disorders were high among sewing machine operators in selected garment industries. Moreover, personal and environmental factors were identified as the potential risk factors related to elbow and wrist musculoskeletal disorders among the study group. Therefore, government and the owner of the garment industries should give special attention to prevent and control the problems through proper occupational health and safety policy implementation in the country.

Environmental and Organizational Factors Associated with Elbow/Forearm and Hand/Wrist Disorder among Sewing Machine Operators of Garment Industry in Ethiopia

PubMed Central

Kebede Deyyas, Wakjira; Tafese, Ararso

2014-01-01

Occupational health problems related to upper limp musculoskeletal disorders were the major issue among sewing machine operators of garment industries in Ethiopia. The aim of this study was to assess the prevalence and associated risk factors of work related elbow and wrist musculoskeletal disorders among sewing machine operators of garment industries in Galan City, Oromia Regional State. A cross-sectional study was conducted from April 1 to 30, 2012. A total of 422 study subjects were included in this study. Standard Nordic Musculoskeletal Questionnaire was used to collect detailed information on musculoskeletal symptom, sociodemographic data, and factors associated with the problems through face to face interview. From a total of 422 sewing machine operators included in the study 370 (87.7%) were females and 306 (72.5%) were in the age group of <30 years. The prevalence of self-reported work related elbow and wrist musculoskeletal disorders was 40% and 37.7%, respectively. In multivariate analysis, those who had >16 years of service were about five times more likely to develop elbow and wrist musculoskeletal disorders than those who had short (1–5 years) year of services [AOR = 4.7, 95% CI: 1.55–13.02], physical activities [AOR = 5.02, 95% CI: 1.57–16.00], and methods of payment [AOR = 2.01, 95% CI: 1.23–3.28], factors significantly associated with this disorders. Work related elbow and wrist musculoskeletal disorders were high among sewing machine operators in selected garment industries. Moreover, personal and environmental factors were identified as the potential risk factors related to elbow and wrist musculoskeletal disorders among the study group. Therefore, government and the owner of the garment industries should give special attention to prevent and control the problems through proper occupational health and safety policy implementation in the country. PMID:25298780

Scapular instability associated with brachial plexus irritation: a proposed causative relationship with treatment implications.

PubMed

Langley, P

1997-01-01

Brachial plexus irritation and other compression neuropathies can be diverse in their presentations and can cause a myriad of signs and symptoms. The purpose of this paper is to review the pertinent anatomy, kinesiology, and neurophysiology and to outline one possible cascade of events that may contribute to more diffuse upper extremity symptoms. Scapular instability and local myofascial trigger points resulting in possible secondary muscle imbalances are described. Their possible relationship to brachial plexus irritation in addition to the implications of the irritation are also discussed. The author postulates that proximal nerve irritation in the region of the thoracic outlet and shoulder may help to account for diffuse or unrelieved symptoms following conventional treatment of distal extremity problems in patients with occupational or cumulative trauma disorders. This paper outlines specific examination procedures for the therapist, which include upper limb tension testing, extensibility testing of the pectoralis minor, and gross manual muscle testing of the lower trapezius.

Musculoskeletal disorders of the neck and shoulder in dental hygienists and dental hygiene students.

PubMed

Morse, Tim; Bruneau, Heather; Michalak-Turcotte, Claudia; Sanders, Martha; Warren, Nicholas; Dussetschleger, Jeff; Diva, Ulysses; Croteau, Marc; Cherniack, Martin

2007-01-01

Dental hygienists have been found to have high rates of neck and shoulder disorders, but there is very limited information on risk factors associated with those disorders, the level of risk for students, and the relationship of prior work as dental assistants for dental hygiene students. This study examines self-reported and physician-diagnosed neck and shoulder pain. A cohort consisting of 27 dental hygiene students with no prior dental occupation experience (mean age 24, 6.2 SD), and 39 dental hygiene students with prior experience as dental assistants (mean age 28, 6.0) and 94 experienced dental hygienists (mean age 46, 8.8) completed a questionnaire on risk factors and self reported pain, and were examined by a physician in reference to upper extremity findings and diagnoses. Analysis included tabular, trend, and logistic regression analysis. There were significant differences for risks, symptoms, and physician findings. Risk factors had a stepwise progression for students, student/assistants, and experienced dental hygienists, including working with a bent neck often or very often (79%, 89%, 96%, respectively, p<.001), static posture (39%, 50%, 63%, p<.001), precise motions (58%, 67%, 90%, p<.001), and repetition (79%, 86%, 98%, p<.001). Neck symptoms were reported by 37%, 43%, and 72%, respectively (p<.001), and 11%, 20%, and 35% for shoulder symptoms (p<.05). Similar patterns were demonstrated in physician findings, particularly for neck disorders (18%, 36%, 50%, p<.01). In regressions, self-reported shoulder pain was significantly associated with working above shoulder height (OR=1.5, CI 1.0-2.4), and neck symptoms with working with a bent neck (OR=2.1, CI 1.3-3.4), with a protective effect from high supervisor support (OR=0.5, CI 0.2-1.0). Risk factors and both self-reported and physician-diagnosed neck and shoulder symptoms increase in frequency from students to experienced hygienists, and students have higher prevalence if they are also dental assistants.

Gender differences in workers with identical repetitive industrial tasks: exposure and musculoskeletal disorders.

PubMed

Nordander, Catarina; Ohlsson, Kerstina; Balogh, Istvan; Hansson, Gert-Ake; Axmon, Anna; Persson, Roger; Skerfving, Staffan

2008-08-01

For unknown reasons, females run a higher risk than males of work-related musculoskeletal disorders. The aim of this study was to evaluate whether male and female workers, with identical repetitive work tasks, differ concerning risk of disorders, physical or psychosocial exposures. Employees in two industries were studied; one rubber manufacturing and one mechanical assembly plant. These industries were selected since in both, large groups of males and females worked side by side performing identical repetitive work tasks. Physical exposure was measured by technical equipment. Postures and movements were registered by inclinometry for the head and upper arms, and by electrogoniometry for the wrists. Muscular activity (muscular rest and %max) was registered by surface electromyography for m. trapezius and the forearm extensors (18 males and 19 females). Psychosocial work environment was evaluated by the demand-control-support model (85 males and 138 females). Musculoskeletal disorders were assessed (105 males and 172 females), by interview (last 7-days complaints), and by physical examination (diagnoses). Concerning physical exposure, females showed higher muscular activity related to maximal voluntary contractions [(%MVE); m. trapezius: females 18 (SD 9.2), males 12 (SD 4.3); forearm extensors: females 39 (SD 11), males 27 (SD 10), right side, 90th percentile]. Working postures and movements were similar between genders. Also, concerning psychosocial work environment, no significant gender differences were found. Females had higher prevalences of disorders [complaints: age-adjusted prevalence odds ratio (POR) 2.3 (95% CI 1.3-3.8) for neck/shoulders, 2.4 (1.4-4.0) for elbows/hands; diagnoses: neck/shoulder 1.9 (1.1-3.6), elbows/hands 4.1 (1.2-9.3)]. In 225 workers, PORs were adjusted for household work, personal recovery and exercise, which only slightly affected the risk estimates. In identical work tasks, females showed substantially higher muscular activity in relation to capacity, and higher prevalence of musculoskeletal disorders of the neck and upper extremity, than did males.

Reliability and validity of the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower limb musculoskeletal disorders.

PubMed

Negahban, Hossein; Hessam, Masumeh; Tabatabaei, Saeid; Salehi, Reza; Sohani, Soheil Mansour; Mehravar, Mohammad

2014-01-01

The aim was to culturally translate and validate the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower extremity musculoskeletal disorders (n = 304). This is a prospective methodological study. After a standard forward-backward translation, psychometric properties were assessed in terms of test-retest reliability, internal consistency, construct validity, dimensionality, and ceiling or floor effects. The acceptable level of intraclass correlation coefficient >0.70 and Cronbach's alpha coefficient >0.70 was obtained for the Persian LEFS. Correlations between Persian LEFS and Short-Form 36 Health Survey (SF-36) subscales of Physical Health component (rs range = 0.38-0.78) were higher than correlations between Persian LEFS and SF-36 subscales of Mental Health component (rs range = 0.15-0.39). A corrected item--total correlation of >0.40 (Spearman's rho) was obtained for all items of the Persian LEFS. Horn's parallel analysis detected a total of two factors. No ceiling or floor effects were detected for the Persian LEFS. The Persian version of the LEFS is a reliable and valid instrument that can be used to measure functional status in Persian-speaking patients with different musculoskeletal disorders of the lower extremity. Implications for Rehabilitation The Persian lower extremity functional scale (LEFS) is a reliable, internally consistent and valid instrument, with no ceiling or floor effects, to determine functional status of heterogeneous patients with musculoskeletal disorders of the lower extremity. The Persian version of the LEFS can be used in clinical and research settings to measure function in Iranian patients with different musculoskeletal disorders of the lower extremity.

The effect of three ergonomics interventions on body posture and musculoskeletal disorders among stuff of Isfahan Province Gas Company

PubMed Central

Habibi, Ehsanollah; Soury, Shiva

2015-01-01

Background: Prevalence of work-related musculoskeletal disorders (WMSDs) is high among computer users. The study investigates the effect of three ergonomic interventions on the incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company, including training, sport, and installation of software. Materials and Methods: The study was performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company employees in three phases (phase 1: Evaluation of present situation, phase 2: Performing interventions, and phase 3: Re-evaluation). Participants were divided into three groups (training, exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper limb assessment (RULA) were used. Data collected were analyzed using SPSS software and McNemar test, t-test, and Chi-square test. Results: Based on the evaluations, there was a decrease in musculoskeletal symptoms among the trained group participants after they received the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation of posture showed an average 25 points decrease in the right side of the body and 20 points decrease in the left side of the body in the group subjected to training. Based on t-test, the decrease was significant. Conclusion: The study demonstrated that majority of the participants accepted interventions, which indicates that most of the people were unsatisfied with the work settings and seeking improvement at the workplace. Overall, the findings show that training, chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders. PMID:26430692

Comparison of Muscle Activation during Dominant Hand Wrist Flexion when Writing.

PubMed

Park, Soohee

2013-12-01

[Purpose] This study investigated the difference in muscle activation of the dominant upper extremity in right-handed and left-handed persons during writing. [Subjects] There were 36 subjects (16 left- handers/ 20 right- handers), and the study was conducted from 03/01/2012 to 30/3/2012. [Methods] Six electrodes were attached to the FCU (flexor carpi ulnaris), FCR (flexor carpi radialis), ECU (extensor carpi ulnaris), ECR (extensor carpi radialis), and both UT (upper trapezius) muscles. [Results] FCU muscle activation was 16.77±9.12% in left-handers and 10.29±4.13% (%MVIC) in right-handers. FCR muscle activation was 19.09±9.43% in left-handers and 10.64±5.03% in right-handers. In addition, the UT muscle activation on the writing hand side was 11.91±5.79% in left-handers and 1.66±1.19% in right-handers. [Conclusion] As a result of this study, it was discovered that left-handers used more wrist flexion in performance of the writing task with the dominant upper extremity than right-handers, and that the left-handers activated the wrist and shoulder muscles more than the right-handers. These results indicate a potential danger of musculoskeletal disease in left-hander.

Trends of weekly musculoskeletal pain from 2000 to 2012: National study of Finnish university students.

PubMed

Oksanen, A M; Laimi, K; Löyttyniemi, E; Kunttu, K

2014-10-01

There are no nationwide trend surveys of the prevalence of musculoskeletal symptoms among university students. The aim of the study was to examine whether the prevalence of perceived musculoskeletal pain symptoms among Finnish university students has changed from 2000 to 2012, and to explore the co-occurrence of these symptoms. Four cross-sectional nationwide representative samples (n = 11,502) were compared in 2000 (n = 3174), 2004 (n = 3153), 2008 (n = 2750) and 2012 (n = 2425). The prevalence of weekly neck-shoulder, lower back, limb or joint, and temporomandibular joint pain was studied. All the studied pains increased significantly from 2000 to 2012. The prevalence rate of neck-shoulder pain increased from 25% to 29%, lower back pain from 10% to 14%, and limb and joint pain increased from 7% to 8%. The prevalence of pain in temporomandibular joint increased from 4% to 5%. In addition, the co-occurrence of different musculoskeletal pain symptoms increased. All of these pain symptoms were more common among female students and among older students. An increasing trend in the prevalence of frequent musculoskeletal pain was found over the period of 12-years among Finnish university students. © 2014 European Pain Federation - EFIC®

Upper limb strength estimation of physically impaired persons using a musculoskeletal model: A sensitivity analysis.

PubMed

Carmichael, Marc G; Liu, Dikai

2015-01-01

Sensitivity of upper limb strength calculated from a musculoskeletal model was analyzed, with focus on how the sensitivity is affected when the model is adapted to represent a person with physical impairment. Sensitivity was calculated with respect to four muscle-tendon parameters: muscle peak isometric force, muscle optimal length, muscle pennation, and tendon slack length. Results obtained from a musculoskeletal model of average strength showed highest sensitivity to tendon slack length, followed by muscle optimal length and peak isometric force, which is consistent with existing studies. Muscle pennation angle was relatively insensitive. The analysis was repeated after adapting the musculoskeletal model to represent persons with varying severities of physical impairment. Results showed that utilizing the weakened model significantly increased the sensitivity of the calculated strength at the hand, with parameters previously insensitive becoming highly sensitive. This increased sensitivity presents a significant challenge in applications utilizing musculoskeletal models to represent impaired individuals.

Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

PubMed

Andersen, Johan H; Fallentin, Nils; Thomsen, Jane F; Mikkelsen, Sigurd

2011-05-12

To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

Development of an Ergonomics Checklist for Investigation of Work-Related Whole-Body Disorders in Farming - AWBA: Agricultural Whole-Body Assessment.

PubMed

Kong, Y K; Lee, S J; Lee, K S; Kim, G R; Kim, D M

2015-10-01

Researchers have been using various ergonomic tools to study occupational musculoskeletal diseases in industrial contexts. However, in agricultural work, where the work environment is poorer and the socio-psychological stress is high due to the high labor intensities of the industry, current research efforts have been scarce, and the number of available tools is small. In our preliminary studies, which focused on a limited number of body parts and other working elements, we developed separate evaluation tools for the upper and lower extremities. The current study was conducted to develop a whole-body ergonomic assessment tool for agricultural work that integrates the existing assessment tools for lower and upper extremities developed in the preliminary studies and to verify the relevance of the integrated assessment tool. To verify the relevance of the Agricultural Whole-Body Assessment (AWBA) tool, we selected 50 different postures that occur frequently in agricultural work. Our results showed that the AWBA-determined risk levels were similar to the subjective risk levels determined by experts. In addition, as the risk level increased, the average risk level increased to a similar extent. Moreover, the differences in risk levels between the AWBA and expert assessments were mostly smaller than the differences in risk levels between other assessment tools and the expert assessments in this study. In conclusion, the AWBA tool developed in this study was demonstrated to be appropriate for use as a tool for assessing various postures commonly assumed in agricultural work. Moreover, we believe that our verification of the assessment tools will contribute to the enhancement of the quality of activities designed to prevent and control work-related musculoskeletal diseases in other industries.

Relations between work and upper extremity musculoskeletal problems (UEMSP) and the moderating role of psychosocial work factors on the relation between computer work and UEMSP.

PubMed

Nicolakakis, Nektaria; Stock, Susan R; Abrahamowicz, Michal; Kline, Rex; Messing, Karen

2017-11-01

Computer work has been identified as a risk factor for upper extremity musculoskeletal problems (UEMSP). But few studies have investigated how psychosocial and organizational work factors affect this relation. Nor have gender differences in the relation between UEMSP and these work factors  been studied. We sought to estimate: (1) the association between UEMSP and a range of physical, psychosocial and organizational work exposures, including the duration of computer work, and (2) the moderating effect of psychosocial work exposures on the relation between computer work and UEMSP. Using 2007-2008 Québec survey data on 2478 workers, we carried out gender-stratified multivariable logistic regression modeling and two-way interaction analyses. In both genders, odds of UEMSP were higher with exposure to high physical work demands and emotionally demanding work. Additionally among women, UEMSP were associated with duration of occupational computer exposure, sexual harassment, tense situations when dealing with clients, high quantitative demands and lack of prospects for promotion, and among men, with low coworker support, episodes of unemployment, low job security and contradictory work demands. Among women, the effect of computer work on UEMSP was considerably increased in the presence of emotionally demanding work, and may also be moderated by low recognition at work, contradictory work demands, and low supervisor support. These results suggest that the relations between UEMSP and computer work are moderated by psychosocial work exposures and that the relations between working conditions and UEMSP are somewhat different for each gender, highlighting the complexity of these relations and the importance of considering gender.

The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis.

PubMed

Kenis-Coskun, Ozge; Karadag-Saygi, Evrim; Bahar-Ozdemir, Yeliz; Gokdemir, Yasemin; Karadag, Bulent; Kayhan, Onder

2017-11-21

Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF. Patients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability. Fifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p = 0.006 and p = 0.01) and spine appearance and movement (p = 0.001 and p = 0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45 ± 7.79 while it was 20.47 ± 6.95 in the CF group (p = 0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters. In patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.

Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.

PubMed

Flodgren, G; Heiden, M; Lyskov, E; Crenshaw, A G

2007-03-01

In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

Pain in hereditary neuropathy with liability to pressure palsy: an association with fibromyalgia syndrome?

PubMed

Yilmaz, Ugur; Bird, Thomas T; Carter, Gregory T; Wang, Leo H; Weiss, Michael D

2015-03-01

This study characterizes the nature of pain in hereditary neuropathy with liability to pressure palsy (HNPP). This retrospective study was performed to assess duration, nature, location, and intensity of pain on initial presentation of subjects with HNPP, including the degree and type of analgesic medication use and electrodiagnostic characteristics. Subjects who met the American College of Rheumatology criteria for fibromyalgia syndrome (FMS) were also identified. Of 32 HNPP subjects, 24 (75%) had symptoms of pain, and 4 (12%) had pain as an initial symptom. Of subjects who described pain, 9 (28%) reported only musculoskeletal pain, 10 (31%) only neuropathic pain, and 5 (16%) both musculoskeletal and neuropathic pain. All 9 subjects with only musculoskeletal pain met criteria for FMS. Neuropathic and musculoskeletal pain occur commonly in HNPP and may be a presenting symptom. Additionally, HNPP with predominantly musculoskeletal pain may meet criteria for FMS and potentially delay the diagnosis. © 2014 Wiley Periodicals, Inc.

Work organization and health among immigrant women: Latina manual workers in North Carolina.

PubMed

Arcury, Thomas A; Grzywacz, Joseph G; Chen, Haiying; Mora, Dana C; Quandt, Sara A

2014-12-01

We sought to describe work organization attributes for employed immigrant Latinas and determine associations of work organization with physical health, mental health, and health-related quality of life. We conducted a cross-sectional survey with 319 employed Latinas in western North Carolina (2009-2011). Measures included job demands (heavy load, awkward posture, psychological demand), decision latitude (skill variety, job control), support (supervisor control, safety climate), musculoskeletal symptoms, mental health (depressive symptoms), and mental (MCS) and physical component score (PCS) health-related quality of life. Three fifths reported musculoskeletal symptoms. Mean scores for depression, MCS, and PCS were 6.2 (SE = 0.2), 38.3 (SE = 0.5), and 42.8 (SE = 0.3), respectively. Greater job demands (heavy load, awkward posture, greater psychological demand) were associated with more musculoskeletal and depressive symptoms and worse MCS. Less decision latitude (lower skill variety, job control) was associated with more musculoskeletal and depressive symptoms. Greater support (supervisor's power and safety climate) was associated with fewer depressive symptoms and better MCS. Work organization should be considered to improve occupational health of vulnerable women workers. Additional research should delineate the links between work organization and health among vulnerable workers.

Coping with Musculoskeletal Pain: Implications for Office Workers

ERIC Educational Resources Information Center

Oztug, Ozhan; Cowie, Helen

2011-01-01

The aim of the present research was to understand how office workers cope with back, neck and upper limb musculoskeletal disorders at work (and their implications for work). A small (N = 120) questionnaire survey collected information about potential participants' background and history of musculoskeletal disorders. These data were used to inform…

Discordance between self-reported arthritis and musculoskeletal signs and symptoms in older women.

PubMed

Lo, Tkt; Parkinson, Lynne; Cunich, Michelle; Byles, Julie

2016-12-01

Arthritis is a gendered disease where women have a higher prevalence and more disability than men with arthritis of the same age. Health survey data is a major source of information for monitoring of the burden of arthritis. The validity of self-reported arthritis and the determinants of its accuracy among women have not been thoroughly studied. The objectives of this study were to: 1) examine the agreement between self-report diagnosed arthritis and musculoskeletal signs and symptoms in community-living older women; 2) estimate the sensitivity, specificity, and predictive values of self-reported arthritis; and 3) assess the factors associated with the disagreement. A cross-sectional survey of women was undertaken in 2012-13. The health survey asked women about diagnosed arthritis and musculoskeletal signs and symptoms. Agreement between self-reported arthritis and musculoskeletal signs symptoms was measured by Cohen's kappa. Sensitivity, specificity, and predictive values of self-reported arthritis were estimated using musculoskeletal signs and symptoms as the reference standard. Factors associated with disagreement between self-reported arthritis and the reference standard were examined using multiple logistic regression. There were 223 participants self-reported arthritis and 347 did not. A greater number of participants who self-reported arthritis were obese compared to those who did not report arthritis. Those who reported arthritis had worse health, physical functioning, and arthritis symptom measures. Among the 570 participants, 198 had musculoskeletal signs and symptoms suggesting arthritis (the reference standard). Agreement between self-reported arthritis and the reference standard was moderate (kappa = 0.41). Sensitivity, specificity, and positive and negative predictive values of self-reported arthritis in older women were 66.7, 75.5, 59.2, and 81.0% respectively. Regression analysis results indicated that false-positive is associated with better health measured by the Short Form 36 physical summary score, the Health Assessment Questionnaire disability index, or the Western Ontario and McMaster University Osteoarthritis Index total score; whereas false-negative is negatively associated with these variables. While some women who reported diagnosed arthritis did not have recent musculoskeletal signs or symptoms, others with the signs and symptoms did not report diagnosed arthritis. Researchers should use caution when employing self-reported arthritis as the case-definition in epidemiological studies.

[Musculoskeletal symptoms in patients with post-polio syndrome].

PubMed

Balzien, B; Hofner, B; Harlander-Weikert, E; Frommelt, P; Bork, H; Forst, R; Fujak, A

2014-06-01

The prevalence of the post-polio syndrome (PPS) is in estimated 50 % of persons with established poliomyelitis with a subsequently stable phase of at least 15 years. The basic mechanism is a loss of motoneuron cells in the spinal cord resulting in muscle weakness and fatigue. In addition pain, cold intolerance and a loss of stamina are frequently reported. There are few studies focusing on the orthopaedic symptoms in the PPS. This study should support the health-care professionals to the address the needs of PPS patients. A questionnaire was developed to collect data on patients who have been diagnosed by a neurologist as fulfilling the criteria of a PPS. It consists of two parts. In the first part, general patient data are collected. In the second part, details of health, pain, and activities of daily living are collected at two points in time: the time of the stable phase immediately after the acute phase of the disease and the phase after the PPS diagnosis. The questionnaires were sent to patients with a diagnosis of PPS. A total of 124 questionnaires were analysed (male: 45, female: 79). Parts of the data were used to calculate a score. It was hypothesised that the score would demonstrate a higher load of orthopaedic symptoms in the PPS phase. The results show that the phase after poliomyelitis (stable phase vs. PPS phase) was associated with significantly different sum score relating to the orthopaedic impairments. The score in the stable phase is on average 18.6 units lower than that in the post-PPS diagnosis phase (p < 0.001). The hypothesis that in the PPS phase the load of orthopaedic symptoms is increased is confirmed by our data. The "loss of functioning in the upper extremity" is also significantly associated with the score (p = 0.004). At the time the survey was taken, patients reveal a high level of musculoskeletal impairments and disabilities after PPS than during the stable phase with regard to general health as well as pain status and performance of daily activities. Age has no significant impact. Many of the patients are severely limited, especially with regard to activities such as walking, climbing stairs, and performing simple household tasks. Since there is no causal therapy for the underlying degeneration of the anterior horn cell pools, treatment is focused on the compensation of the functional limitations. Georg Thieme Verlag KG Stuttgart · New York.

Risk Factors for Musculoskeletal Symptoms Among Korean Broadcast Actors.

PubMed

Park, Moon-Hee; Kim, Ham-Gyum; Cho, Jae-Hwan

2015-01-01

Musculoskeletal diseases (MSDs) are functional disabilities in the musculoskeletal area that occur when continuous damage to the muscles or tissues is caused by performing a repetitive task. These diseases are usually found in the waist, shoulder, neck, arm, and wrist. MSD is also referred to as cumulative trauma disorder, repetitive strain injury, occupational overuse syndrome, and visual display terminal, depending on the country. The condition is now commonly referred to as work-related musculoskeletal disorder. The aim of this study was to develop a prevention plan against musculoskeletal disease and to provide better health care to broadcast actors by understanding the association between musculoskeletal symptoms and working conditions. The results of the study can be utilized to maintain effective systematic resources to treat such diseases. A survey was conducted in Seoul between January 1 and May 10, 2014 with broadcast actors working in the South Korean entertainment industry. Tests with respect to musculoskeletal symptoms indicated that the study participants were likely to experience having musculoskeletal symptoms in the shoulders, waist, neck, leg/foot, hand/wrist/finger, and arm/elbow. Most of the participants reported pain on both sides of their shoulders and in their legs/feet or on the right side of the arm/elbow and in hand/wrist/finger. Pain lasted between 1 and 7 days, with an incidence of 33.8% in the neck, 36% in the shoulders, 33.3% in the arm/elbow, 47.4% in the hand/wrist/finger, 34.7% in the waist, and 39.3% in the leg/foot. This study should prove useful in determining systematic and effective resources to prevent broadcast actors from developing MSD in the future. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The Prevalence of and Risk Factors Associated with Musculoskeletal Disorders among Sonographers in Central China: A Cross-Sectional Study

PubMed Central

Feng, Qingmin; Liu, Shenglin; Yang, Lei; Xie, Mingxing

2016-01-01

Objective Studies from industrialized countries show that musculoskeletal disorders (MSD) occur commonly in sonographers. However, little is known about sonographers in China, where the awareness of ergonomics and MSD, workload, and available equipment/facilities may differ. We aimed to investigate the prevalence of MSD and associated risk factors in sonographers in central China. Methods A cross-sectional survey was conducted with 381 sonographers from 14 randomly selected tertiary hospitals in Hubei province, central China. Musculoskeletal symptoms (using the Nordic Questionnaire) and risk factors (mostly derived from the Health Benefit Trust survey instrument and the Dutch Musculoskeletal Questionnaire) were recorded. Multivariate logistic regression was used to quantify associations between risk factors and MSD. Results The 12-month period prevalence of MSD was 98.3%, being highest in the neck (93.5%) and shoulder (92.2%), followed by the lower back (83.2%), wrist/hand, upper back, and elbow. Factors contributing to neck pain were psychological fatigue, shoulder abduction and trunk bend-and-twist posture. Height-adjustable tables and chairs were protective factors. Shoulder pain was associated with female sex, health status, mental stress, shoulder abduction, and trunk bend-and-twist posture. Height-adjustable chairs and the awareness of adjusting the workstation before scanning were protective factors. Elbow pain was associated with health status and height-adjustable tables. Wrist/hand pain was associated with female sex, bending the wrist, and working with obese patients. Upper back pain was associated with shoulder abduction, height-adjustable chairs, and device location. Lower back pain was associated with the number of scans performed per day, awkward postures, bending the trunk, twisting or bending the neck forward, and using a footrest. Conclusions This study suggests a high prevalence of MSD in sonographers in central China. Hence, it is necessary to improve the awareness of MSD by training, and the ergonomics of their current work environment by addressing physical workload, and psychological and equipment/facility-related factors. PMID:27695095

Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study

PubMed Central

El-Metwally, Ashraf; Salminen, Jouko J; Auvinen, Anssi; Macfarlane, Gary; Mikkelsson, Marja

2007-01-01

Background Musculoskeletal pain symptoms are common in children and adolescents. These symptoms have a negative impact on children's physical and emotional well-being, but their underlying aetiology and risk factors are still poorly understood. Most of the previous cohort studies were conducted among mid and/or late adolescents and were mainly focused on a specific pain location (e.g. low back pain or neck pain). The purpose of this study is to estimate occurrence of new-onset pain symptoms, in all musculoskeletal locations, in preteens and early adolescents and investigate risk factors for development of these symptoms. Methods 1756 schoolchildren (mean age 10.8) were recruited from schools in southern Finland. Information was extracted as to whether they experienced musculoskeletal pain and a total of 1192 children were identified as free of musculoskeletal pain symptoms. Information was collected on factors which could potentially predict the development of musculoskeletal pain: headache, abdominal pain, sadness/feeling down, day-time tiredness, difficulty in falling asleep, waking up during nights, level of physical activity and hypermobility. These children were followed-up 1-year later and those with new episodes of non-traumatic and traumatic musculoskeletal pain symptoms were identified. Results A total of 1113 schoolchildren (93% of baseline pain-free children) were found at one-year follow-up. New episodes of musculoskeletal pain were reported by 21.5% of these children. Of them 19.4% reported non-traumatic pain and 4.0% reported traumatic pain. The neck was the most commonly reported site with non-traumatic pain, while the lower limb was the most common site for traumatic pain. The independent risk factors for non-traumatic musculoskeletal pain were headache (OR = 1.68, [95% CI 1.16–2.44]) and day-time tiredness (OR = 1.53, [95% CI 1.03–2.26]). The risk factors for traumatic musculoskeletal pain were vigorous exercise (OR = 3.40 [95% CI 1.39–8.31]) and day-time tiredness (OR = 2.97 [95% CI 1.41–6.26]). Conclusion This study highlights that there may be two types of pain entities with both distinct and common aspects of aetiology. For primary prevention purposes, school healthcare professionals should pay attention to preteens and early adolescents practicing vigorous exercise (predictor of traumatic pain), reporting headache (predictor of non-traumatic pain) and reporting day-time tiredness (predictor of both types of pain). PMID:17521435

Non-Small Cell Lung Carcinoma: Clinical Reasoning in the Management of a Patient Referred to Physical Therapy for Costochondritis.

PubMed

Hensley, Craig P; Emerson, Alicia J

2018-06-01

Chest pain, a frequent complaint for seeking medical care, is often attributed to musculoskeletal pathology. Costochondritis is a common disorder presenting as chest pain. Initial physical therapist examination emphasizes red flag screening. Reexamination throughout the episode of care is critical, particularly when patients are not progressing and/or in the presence of complex pain presentations. The purpose of this case report is to describe the clinical reasoning process in the management of a patient referred to physical therapy with a medical diagnosis of costochondritis. A 59-year-old woman presented with a 5-month history of left-sided chest pain that had progressed to include the cervical and shoulder regions. She reported multiple psychosocial stressors; a depression screen was positive. She reported a history of asthma and smoking and improvement in recent fatigue, coughing, dyspnea, and sweating. At the initial visit, shoulder, cervical, and thoracic active and passive range of motion and joint mobility testing reproduced her pain. Allodynia was present throughout the painful areas in the left upper quarter. The patient demonstrated improvement over 30 days (4 visits). On her fifth visit (day 35), she reported an exacerbation of her chest and upper extremity pain and noted increased fatigue, sweating, dyspnea, and loss of appetite. Even though her pain was again reproduced with musculoskeletal testing, the physical therapist contacted the patient's physician regarding the change in presentation. A subsequent chest computed tomography scan revealed a non-small cell lung adenocarcinoma. Cancer can masquerade as a musculoskeletal condition. This case highlights the importance of screening, clinical reasoning, and communication throughout the episode of care, particularly in the presence of chronic pain and psychosocial stressors.

Functional Multijoint Position Reproduction Acuity in Overhead-Throwing Athletes

PubMed Central

Tripp, Brady L; Uhl, Timothy L; Mattacola, Carl G; Srinivasan, Cidambi; Shapiro, Robert

2006-01-01

Context: Baseball players rely on the sensorimotor system to uphold the balance between upper extremity stability and mobility while maintaining athletic performance. However, few researchers have studied functional multijoint measures of sensorimotor acuity in overhead-throwing athletes. Objective: To compare sensorimotor acuity between 2 high-demand functional positions and among planes of motion within individual joints and to describe a novel method of measuring sensorimotor function. Design: Single-session, repeated-measures design. Setting: University musculoskeletal research laboratory. Patients or Other Participants: Twenty-one National Collegiate Athletic Association Division I baseball players (age = 20.8 ± 1.5 years, height = 181.3 ± 5.1 cm, mass = 87.8 ± 9.1 kg) with no history of upper extremity injury or central nervous system disorder. Main Outcome Measure(s): We measured active multijoint position reproduction acuity in multiple planes using an electromagnetic tracking device. Subjects reproduced 2 positions: arm cock and ball release. We calculated absolute and variable error for individual motions at the scapulothoracic, glenohumeral, elbow, and wrist joints and calculated overall joint acuity with 3-dimensional variable error. Results: Acuity was significantly better in the arm-cock position compared with ball release at the scapulothoracic and glenohumeral joints. We observed significant differences among planes of motion within the scapulothoracic and glenohumeral joints at ball release. Scapulothoracic internal rotation and glenohumeral horizontal abduction and rotation displayed less acuity than other motions. Conclusions: We established the reliability of a functional measure of upper extremity sensorimotor system acuity in baseball players. Using this technique, we observed differences in acuity between 2 test positions and among planes of motion within the glenohumeral and scapulothoracic joints. Clinicians may consider these differences when designing and implementing sensorimotor system training. Our error scores are similar in magnitude to those reported using single-joint and single-plane measures. However, 3-dimensional, multijoint measures allow practical, unconstrained test positions and offer additional insight into the upper extremity as a functional unit. PMID:16791298

[Analysis of subjective symptoms of upper extremities in dental technicians].

PubMed

Yoshida, H; Nagata, C; Mirbod, S M; Iwata, H; Inaba, R

1991-01-01

Our review of the literature showed no report on the subjective symptoms of the upper extremities in dental technicians. This study was therefore undertaken on 164 dental technicians in Gifu Prefecture to investigate the relationship between the subjective symptoms of the hands, arms and shoulders and work of dental technicians. The following results were obtained. 1) The prevalence of Raynaud's phenomenon and numbness of the fingers was 5.5 and 18.5 %, respectively. A significant positive correlation was observed between the prevalence and frequency of numbness and cold sensation in the fingers and the daily usage time (h) of high-speed type machines. In addition, pain in the fingers and around the wrists, and pain and numbness in the arms were significantly related to the daily usage time (h) of low-speed type machines. These results suggest that the usage of high- and low-speed type machines may be a cause of vibration syndrome among dental technicians. 2) A high prevalence of pain in the shoulders (30.8%), neck (30.1%), and back (36.3%) was observed in dental technicians. It is considered that these symptoms are related to the working posture and usage of machines.

[Diagnosis of musculoskeletal ambulation disability symptom complex (MADS)].

PubMed

Ito, Hiromoto

2008-11-01

It was described to diagnosis of Musculoskeletal Ambulation Disability Symptom Complex (MADS). The definition of MADS is an person of advanced years with lower leveled balance and walking ability, high risk for fall, and who is keeping to the house. The diagnosis of MADS was decided to a history of 11 musculoskeletal disorders and evaluation of balanced and walking function. The determination method of time of one leg standing and 3 m timed timed up and go test were described.

Musculoskeletal Model-Guided, Customizable Selection of Shoulder and Elbow Muscles for a C5 SCI Neuroprosthesis

PubMed Central

Hincapie, Juan Gabriel; Blana, Dimitra; Chadwick, Edward K.; Kirsch, Robert F.

2010-01-01

Individuals with C5/C6 spinal cord injury (SCI) have a number of paralyzed muscles in their upper extremities that can be electrically activated in a coordinated manner to restore function. The selection of a practical subset of paralyzed muscles for stimulation depends on the specific condition of the individual, the functions targeted for restoration, and surgical considerations. This paper presents a musculoskeletal model-based approach for optimizing the muscle set used for functional electrical stimulation (FES) of the shoulder and elbow in this population. Experimentally recorded kinematics from able-bodied subjects served as inputs to a musculoskeletal model of the shoulder and elbow, which was modified to reflect the reduced muscle force capacities of an individual with C5 SCI but also the potential of using FES to activate paralyzed muscles. A large number of inverse dynamic simulations mimicking typical activities of daily living were performed that included 1) muscles with retained voluntary control and 2) many different combinations of stimulated paralyzed muscles. These results indicate that a muscle set consisting of the serratus anterior, infraspinatus and triceps would enable the greatest range of relevant movements. This set will become the initial target in a C5 SCI neuroprosthesis to restore shoulder and elbow function. PMID:18586604

The clinical profile of musculoskeletal injuries in children attending a major hospital in Delhi, India

PubMed Central

Sural, Sumit; Verma, Anu

2015-01-01

Background Children are vulnerable to musculoskeletal injuries both at home and on the street for various reasons. Morbidity and disabilities resulting from these, mostly preventable, injuries, make them a burden to their families and society. The role of various factors associated with injuries is often not documented. Methods This prospective study, done on 100 children aged up to 12 years with musculoskeletal trauma, analysed in details, the various modes of injuries. Results One in every five patient was a child below 12 years of age. Boys were injured more than girls. Injuries, especially fractures, were most common in the extremities, the upper limb more commonly injured than the lower limb. Most of the injuries occurred at home. The most common mode of injuries was falls that happened while playing both within and outside the home, followed by road traffic accidents. Most injuries occurred during daytime. Conclusions Injuries in children were found to be preventable. Small interventions while constructing homes can contribute tremendously to injury prevention and control in children. Parental awareness about the various modes of injury, role of supervised playing and their responsibility towards injury prevention can play a key role in reducing the morbidity associated with childhood fractures. PMID:26549946

Musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability.

PubMed

Kavlak, Erdoğan; Altuğ, Filiz; Büker, Nihal; Şenol, Hande

2015-01-01

The objective of this study is to investigate musculoskeletal system problems and quality of life of mothers of children with cerebral palsy with different levels of disability. 100 children (37 girls and 63 boys) with cerebral palsy (CP) and their mothers were included in this study. Functional levels of children with CP were assessed by using the Gross Motor Function Classification System (GMFCS) and the Pediatric Functional Independence Measure (WeeFIM). Quality of life of mothers regarding health was assessed by using the Nottingham Health Profile (NHP). Musculoskeletal system problems of mothers were assessed by using the Neck Disability Index (NDI) and the Roland-Morris Disability Questionnaire (RMDQ). No statistical significance was found when GMFCS levels of children with CP and the NHP, DASH-T, RMDQ, NDI and the BAE values of mothers were compared in an inter-group way (p> 0.05). When the NHP parameters and the existence of lower and arm pains of mothers were compared with their BAI, NDI, RMDQ and DASH-T scores, a statistically significant relationship was found among them (p< 0.05). As functional levels of children with CP get worse, upper extremity, lower back and neck problems and anxiety levels of mothers increase and this situation negatively affects mothers' quality of life.

Musculoskeletal disorders among workers in plastic manufacturing plants.

PubMed

Fernandes, Rita de Cássia Pereira; Assunção, Ada Avila; Silvany Neto, Annibal Muniz; Carvalho, Fernando Martins

2010-03-01

Epidemiological studies have indicated an association between musculoskeletal disorders (MSDs) and physical work demands. Psychosocial work demands have also been identified as possible risk factors, but findings have been inconsistent. To evaluate factors associated with upper back, neck and upper limb MSD among workers from 14 plastic manufacturing companies located in the city of Salvador, Brazil. A cross-sectional study design was used to survey a stratified proportional random sample of 577 workers. Data were collected by questionnaire interviews. Factor analysis was carried out on 11 physical demands variables. Psychosocial work demands were measured by demand, control and social support questions. The role of socio-demographic factors, lifestyle and household tasks was also examined. Multiple logistic regression was used to identify factors related to upper back, neck and upper limb MSDs. Results from multiple logistic regression showed that distal upper limb MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and gender. Neck, shoulder or upper back MSDs were related to manual handling, work repetitiveness, psychosocial demands, job dissatisfaction, and physical unfitness. Reducing the prevalence of musculoskeletal disorders requires: improving the work environment, reducing biomechanical risk factors, and replanning work organization. Programs must also be aware of gender specificities related to MSDs.

Structural equation model of interactions between risk factors and work-related musculoskeletal complaints among Iranian hospital nurses.

PubMed

Mehralizadeh, Semira; Dehdashti, Alireza; Motalebi Kashani, Masoud

2017-01-01

Statistics indicate a high risk of developing work-related musculoskeletal disorders among hospital nurses. The challenge is to understand the associations between musculoskeletal symptoms and various individual and occupational risk factors. This study examined the direct and indirect interactions of various risk factors with musculoskeletal complaints in hospital nurses. In a cross-sectional design, Iranian hospital nurses from Semnan University of Medical Sciences participated in a questionnaire survey reporting their perceived perceptions of various work-related risk factors and musculoskeletal symptoms. We tested our proposed structural equation model to evaluate the relations between latent and observed concepts and the relative importance and strength of exogenous variables in explaining endogenous musculoskeletal complaints. Measurement model fits the data relatively acceptable. Our findings showed direct effects of psychological, role-related and work posture stressors on musculoskeletal complaints. Fatigue mediated the adverse indirect relations of psychological, role-related, work posture and individual factors with musculoskeletal complaints. Structural equation modeling may provide methodological opportunities in occupational health research with a potential to explain the complexity of interactions among risk factors. Prevention of work-related musculoskeletal disorders among nurses must account for physical and psychosocial conditions.

An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India.

PubMed

Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

2015-01-01

Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS.

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study.

PubMed

Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk; Lee, Sang Chul

2016-03-01

To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0 ± 10.5 years and duration of symptom was 12.2 ± 8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p<0.01). However, injection resulted in greater improvements than stretching exercise (p<0.01). The number of patients with successful treatment, defined as >50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus.

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study

PubMed Central

Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk

2016-01-01

Purpose To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Materials and Methods Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0±10.5 years and duration of symptom was 12.2±8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. Results After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p<0.01). However, injection resulted in greater improvements than stretching exercise (p<0.01). The number of patients with successful treatment, defined as >50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Conclusion Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus. PMID:26847305

Pregnancy-associated osteoporosis with eight fractures in the vertebral column treated with kyphoplasty and bracing: a case report.

PubMed

Bonacker, J; Janousek, M; Kröber, M

2014-02-01

Pregnancy-associated osteoporosis is a rare condition, which imposes multiple symptoms in the musculoskeletal system. Common complaints announced by patients are severe pain in the lower back, hips and the joints of the lower extremities with a reduced and less mobility status in general. Most of the patients' problems occur in the last trimester of pregnancy or postpartum and are often not diagnosed as side effects of osteoporosis but as problems associated with pregnancy. Although vertebral fractures are rare complications of pregnancy-associated osteoporosis, they should be always considered in women presenting with an acute pain syndrome in peripregnancy period. This case presents a 40-year-old primagravid woman who developed pain in hips and severe pain in the lower back causing an immobilization diagnosed with a pregnancy-associated osteoporosis with eight compression fractures in the thoracic and lumbar spine. Because of sagittal imbalance of the spine, she was treated with kyphoplasty at the four lumbar fractures and with bracing for the upper, thoracic ones, additional to the conservative anti-osteoporotic therapy. The authors discuss pregnancy-associated osteoporosis and its clinical presentation, as well as the indications of kyphoplasty, spinal alignment and the risk of single conservative treatment.

Ultrasound-guided corticosteroid injection therapy for juvenile idiopathic arthritis: 12-year care experience.

PubMed

Young, Cody M; Shiels, William E; Coley, Brian D; Hogan, Mark J; Murakami, James W; Jones, Karla; Higgins, Gloria C; Rennebohm, Robert M

2012-12-01

Intra-articular corticosteroid injections are a safe and effective treatment for patients with juvenile idiopathic arthritis. The potential scope of care in ultrasound-guided corticosteroid therapy in children and a joint-based corticosteroid dose protocol designed to optimize interdisciplinary care are not found in the current literature. The purpose of this study was to report the spectrum of care, technique and safety of ultrasound-guided corticosteroid injection therapy in patients with juvenile idiopathic arthritis and to propose an age-weight-joint-based corticosteroid dose protocol. A retrospective analysis was performed of 198 patients (ages 21 months to 28 years) referred for treatment of juvenile idiopathic arthritis with corticosteroid therapy. Symptomatic joints and tendon sheaths were treated as prescribed by the referring rheumatologist. An age-weight-joint-based dose protocol was developed and utilized for corticosteroid dose prescription. A total of 1,444 corticosteroid injections (1,340 joints, 104 tendon sheaths) were performed under US guidance. Injection sites included small, medium and large appendicular skeletal joints (upper extremity 497, lower extremity 837) and six temporomandibular joints. For patients with recurrent symptoms, 414 repeat injections were performed, with an average time interval of 17.7 months (range, 0.5-101.5 months) between injections. Complications occurred in 2.6% of injections and included subcutaneous tissue atrophy, skin hypopigmentation, erythema and pruritis. US-guided corticosteroid injection therapy provides dynamic, precise and safe treatment of a broad spectrum of joints and tendon sheaths throughout the entire pediatric musculoskeletal system. An age-weight-joint-based corticosteroid dose protocol is effective and integral to interdisciplinary care of patients with juvenile idiopathic arthritis.

Work Safety Climate, Musculoskeletal Discomfort, Working While Injured, and Depression Among Migrant Farmworkers in North Carolina

PubMed Central

O’Hara, Heather; Grzywacz, Joseph G.; Isom, Scott; Chen, Haiying; Quandt, Sara A.

2012-01-01

Objectives. This analysis described Latino migrant farmworkers’ work safety climate and its association with musculoskeletal discomfort, working while injured or ill, and depressive symptoms. Methods. Data were from a cross-sectional survey of 300 farmworkers conducted in North Carolina in 2009. Generalized estimating equations models were used to investigate the association of work safety climate with health and safety outcomes. Results. Farmworkers perceived their work safety climate to be poor. About 40% had elevated musculoskeletal discomfort, 5.0% had worked at least 1 day while injured or ill, and 27.9% had elevated depressive symptoms. The odds of elevated musculoskeletal discomfort were 12% lower and the odds of working while injured or ill were 15% lower with each 1-unit increase in the work safety climate. Work safety climate was not associated with depressive symptoms. Conclusions. Work safety climate was important for agricultural workers. Poor work safety climate was associated with health outcomes (musculoskeletal discomfort) and safety (working while injured or ill). Interventions to improve work safety climate in agriculture are needed, with these interventions being directed to employers and workers. PMID:22401520

Work safety climate, musculoskeletal discomfort, working while injured, and depression among migrant farmworkers in North Carolina.

PubMed

Arcury, Thomas A; O'Hara, Heather; Grzywacz, Joseph G; Isom, Scott; Chen, Haiying; Quandt, Sara A

2012-05-01

This analysis described Latino migrant farmworkers' work safety climate and its association with musculoskeletal discomfort, working while injured or ill, and depressive symptoms. Data were from a cross-sectional survey of 300 farmworkers conducted in North Carolina in 2009. Generalized estimating equations models were used to investigate the association of work safety climate with health and safety outcomes. Farmworkers perceived their work safety climate to be poor. About 40% had elevated musculoskeletal discomfort, 5.0% had worked at least 1 day while injured or ill, and 27.9% had elevated depressive symptoms. The odds of elevated musculoskeletal discomfort were 12% lower and the odds of working while injured or ill were 15% lower with each 1-unit increase in the work safety climate. Work safety climate was not associated with depressive symptoms. Work safety climate was important for agricultural workers. Poor work safety climate was associated with health outcomes (musculoskeletal discomfort) and safety (working while injured or ill). Interventions to improve work safety climate in agriculture are needed, with these interventions being directed to employers and workers.

Median and ulnar neuropathies in U.S. Army Medical Command Band members.

PubMed

Shaffer, Scott W; Koreerat, Nicholas R; Gordon, Lindsay B; Santillo, Douglas R; Moore, Josef H; Greathouse, David G

2013-12-01

Musicians have been reported as having a high prevalence of upper-extremity musculoskeletal disorders, including carpal tunnel syndrome. The purpose of this study was to determine the presence of median and ulnar neuropathies in U.S. Army Medical Command (MEDCOM) Band members at Fort Sam Houston, Texas. Thirty-five MEDCOM Band members (30 males, 5 females) volunteered to participate. There were 33 right-handed musicians, and the mean length of time in the MEDCOM Band was 12.2 yrs (range, 1-30 yrs). Subjects completed a history form, were interviewed, and underwent a physical examination of the cervical spine and bilateral upper extremities. Nerve conduction studies of the bilateral median and ulnar nerves were performed. Electrophysiological variables served as the reference standard for median and ulnar neuropathy and included distal sensory latencies, distal motor latencies, amplitudes, conduction velocities, and comparison study latencies. Ten of the 35 subjects (29%) presented with abnormal electrophysiologic values suggestive of an upper extremity mononeuropathy. Nine of the subjects had abnormal median nerve electrophysiologic values at or distal to the wrist; 2 had bilateral abnormal values. One had an abnormal ulnar nerve electrophysiologic assessment at the elbow. Nine of these 10 subjects had clinical examination findings consistent with the electrophysiological findings. The prevalence of mononeuropathies in this sample of band members is similar to that found in previous research involving civilian musicians (20-36%) and far exceeds that reported in the general population. Prospective research investigating screening, examination items, and injury prevention measures in musicians appears to be warranted.

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems

PubMed Central

Blana, Dimitra; Hincapie, Juan G.; Chadwick, Edward K.; Kirsch, Robert F.

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs:motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model-calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems. PMID:18420213

A musculoskeletal model of the upper extremity for use in the development of neuroprosthetic systems.

PubMed

Blana, Dimitra; Hincapie, Juan G; Chadwick, Edward K; Kirsch, Robert F

2008-01-01

Upper extremity neuroprostheses use functional electrical stimulation (FES) to restore arm motor function to individuals with cervical level spinal cord injury. For the design and testing of these systems, a biomechanical model of the shoulder and elbow has been developed, to be used as a substitute for the human arm. It can be used to design and evaluate specific implementations of FES systems, as well as FES controllers. The model can be customized to simulate a variety of pathological conditions. For example, by adjusting the maximum force the muscles can produce, the model can be used to simulate an individual with tetraplegia and to explore the effects of FES of different muscle sets. The model comprises six bones, five joints, nine degrees of freedom, and 29 shoulder and arm muscles. It was developed using commercial, graphics-based modeling and simulation packages that are easily accessible to other researchers and can be readily interfaced to other analysis packages. It can be used for both forward-dynamic (inputs: muscle activation and external load; outputs: motions) and inverse-dynamic (inputs: motions and external load; outputs: muscle activation) simulations. Our model was verified by comparing the model calculated muscle activations to electromyographic signals recorded from shoulder and arm muscles of five subjects. As an example of its application to neuroprosthesis design, the model was used to demonstrate the importance of rotator cuff muscle stimulation when aiming to restore humeral elevation. It is concluded that this model is a useful tool in the development and implementation of upper extremity neuroprosthetic systems.

Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain.

PubMed

Pedersen, Mogens Theisen; Andersen, Christoffer H; Zebis, Mette K; Sjøgaard, Gisela; Andersen, Lars L

2013-10-09

Previous studies have shown positive effects of physical exercise at the workplace on musculoskeletal disorders. However, long-term adherence remains a challenge. The present study evaluates long-term adherence and effects of a workplace strength training intervention on back, neck and upper extremity pain among laboratory technicians. Cluster-randomized controlled trial involving 537 industrial laboratory technicians. Subjects were randomized at the cluster level to one of two groups: training group 1 (TG1, n = 282) performing supervised strength training from February to June 2009 (round one) or training group 2 (TG2, n = 255) performing supervised strength training from August to December 2009 (round two). The outcome measures were changes in self-reported pain intensity (0-9) in the back, neck and upper extremity as well as Disability of the Arm, Shoulder and Hand (DASH, 0-100). Regular adherence, defined as at least one training session per week, was achieved by around 85% in both groups in the supervised training periods. In the intention-to-treat analyses there were significant group by time effects for pain in the neck, right shoulder, right hand and lower back and DASH-resulting in significant reductions in pain (mean 0.3 to 0.5) and DASH (mean 3.9) in the scheduled training group compared to the reference group. For TG1 there were no significant changes in pain in round two, i.e. they maintained the pain reduction achieved in round one. Subgroup analyses among those with severe pain (> = 3 on a scale of 0-9) showed a significant group by time effect for pain in the neck, right shoulder, upper back and lower back. For these subgroups the pain reduction in response to training ranged from 1.1 to 1.8. Specific strength training at the workplace can lead to significant long-term reductions in spinal and upper extremity pain and DASH. The pain reductions achieved during the intensive training phase with supervision appears to be maintained a half year later.

Musculoskeletal symptoms as related to ergonomic factors in Iranian hand-woven carpet industry and general guidelines for workstation design.

PubMed

Choobineh, Alireza; Lahmi, Mohammadali; Shahnavaz, Houshang; Jazani, Reza Khani; Hosseini, Mostafa

2004-01-01

Carpet weaving is a high risk occupation for developing musculoskeletal disorders (MSDs). The objectives of the present study, which was carried out in the Iranian hand-woven carpet industry, were determination of the prevalence of MSD symptoms, identification of major factors associated with MSD symptoms and development of guidelines for workstation design. 1,439 randomly selected weavers participated in this study. A questionnaire was used to collect data on MSD symptoms. The results revealed that the prevalence rates for symptoms in different body regions were high as compared to the general Iranian population (for neck, back and large joints, p <.0001). The results of multivariate analyses showed that major ergonomic factors associated with musculoskeletal symptoms were loom type, working posture, daily working time and seat type. Based on the results, some general guidelines for designing weaving workstations were developed. A prototype test showed that the new workstation was acceptable for subject tests and that it improved working posture.

The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review.

PubMed

van Niekerk, Sjan-Mari; Louw, Quinette Abigail; Hillier, Susan

2012-08-13

Prolonged sitting has been associated with musculoskeletal dysfunction. For desk workers, workstation modifications frequently address the work surface and chair. Chairs which can prevent abnormal strain of the neuromuscular system may aid in preventing musculo-skeletal pain and discomfort. Anecdotally, adjustability of the seat height and the seat pan depth to match the anthropometrics of the user is the most commonly recommended intervention. Within the constraints of the current economic climate, employers demand evidence for the benefits attributed to an investment in altering workstations, however this evidence-base is currently unclear both in terms of the strength of the evidence and the nature of the chair features. The purpose of this study was to evaluate the evidence for the effectiveness of chair interventions in reducing workplace musculoskeletal symptoms. Pubmed, Cinahl, Pedro, ProQuest, SCOPUS and PhysioFocus were searched. 'Ergonomic intervention', 'chair', 'musculoskeletal symptoms', 'ergonomics', 'seated work' were used in all the databases. Articles were included if they investigated the influence of chair modifications as an intervention; participants were in predominantly seated occupations; employed a pre/post design (with or without control or randomising) and if the outcome measure included neuro-musculoskeletal comfort and/or postural alignment. The risk of bias was assessed using a tool based on The Cochrane Handbook. Five studies were included in the review. The number of participants varied from 4 to 293 participants. Three of the five studies were Randomised Controlled Trials, one pre and post-test study was conducted and one single case, multiple baselines (ABAB) study was done. Three studies were conducted in a garment factory, one in an office environment and one with university students. All five studies found a reduction in self-reported musculoskeletal pain immediately after the intervention. Bias was introduced due to poor randomization procedures and lack of concealed allocation. Meta-analysis was not possible due to the heterogeneity of the data (differing population, intervention and outcomes across studies). The findings of this review indicate a consistent trend that supports the role of a chair intervention to reduce musculoskeletal symptoms among workers who are required to sit for prolonged periods. However the amount, level and quality of the evidence are only moderate therefore we cannot make strong recommendations until further trials are conducted. The review also highlights gaps: for example in showing whether the effectiveness of a chair intervention has long-term impact, particularly with respect to musculoskeletal symptoms, as well as the recurrence of symptoms and the consequent cost of care.

Task distribution, work environment, and perceived health discomforts among Indian ceramic workers.

PubMed

Majumder, Joydeep; Shah, Priyanka; Bagepally, Bhavani S

2016-12-01

The study examined the work environment of Indian ceramics workers and assessed associations between work hazards, work category, and self-reported symptoms. The multi-method ergonomic review technique (MMERT) checkpoints was used for work analysis and prevalence of self-reported symptoms among 329 male workers. Ambient temperature and relative humidity in ceramic industries were 39.9°C and 17.4% respectively. Musculoskeletal discomfort was observed as a primary complaint; especially lower extremity pain (45%). Load handlers and machine operators had the highest levels of work hazards, including high skill requirement, strenuous work posture, poor commitment by the organization. Poor job autonomy, task clarity, hot workplace, inappropriate workplace design, inadequate auxiliary support, and mental overload were significantly associated with self-reported symptoms (P < 0.001). Work categories are associated with work hazards and may lead to various health symptoms among ceramic workers. Control of workplace hazards may lower rates of symptoms and thus may lead to improved health, productivity, and well-being. Am. J. Ind. Med. 59:1145-1155, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

PubMed

Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George

2017-01-01

The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

The impact of obesity surgery on musculoskeletal disease.

PubMed

El-Khani, Ussamah; Ahmed, Ahmed; Hakky, Sherif; Nehme, Jean; Cousins, Jonathan; Chahal, Harvinder; Purkayastha, Sanjay

2014-12-01

Obesity is an important modifiable risk factor for musculoskeletal disease. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review of bariatric surgery on musculoskeletal disease symptoms was performed. One thousand nineteen papers were identified, of which 43 were eligible for data synthesis. There were 79 results across 24 studies pertaining to physical capacity, of which 53 (67 %) demonstrated statistically significant post-operative improvement. There were 75 results across 33 studies pertaining to musculoskeletal pain, of which 42 (56 %) demonstrated a statistically significant post-operative improvement. There were 13 results across 6 studies pertaining to arthritis, of which 5 (38 %) demonstrated a statistically significant post-operative improvement. Bariatric surgery significantly improved musculoskeletal disease symptoms in 39 of the 43 studies. These changes were evident in a follow-up of 1 month to 10 years.

College students and computers: assessment of usage patterns and musculoskeletal discomfort.

PubMed

Noack-Cooper, Karen L; Sommerich, Carolyn M; Mirka, Gary A

2009-01-01

A limited number of studies have focused on computer-use-related MSDs in college students, though risk factor exposure may be similar to that of workers who use computers. This study examined computer use patterns of college students, and made comparisons to a group of previously studied computer-using professionals. 234 students completed a web-based questionnaire concerning computer use habits and physical discomfort respondents specifically associated with computer use. As a group, students reported their computer use to be at least 'Somewhat likely' 18 out of 24 h/day, compared to 12 h for the professionals. Students reported more uninterrupted work behaviours than the professionals. Younger graduate students reported 33.7 average weekly computing hours, similar to hours reported by younger professionals. Students generally reported more frequent upper extremity discomfort than the professionals. Frequent assumption of awkward postures was associated with frequent discomfort. The findings signal a need for intervention, including, training and education, prior to entry into the workforce. Students are future workers, and so it is important to determine whether their increasing exposure to computers, prior to entering the workforce, may make it so they enter already injured or do not enter their chosen profession due to upper extremity MSDs.

Office ergonomics training and a sit-stand workstation: effects on musculoskeletal and visual symptoms and performance of office workers.

PubMed

Robertson, Michelle M; Ciriello, Vincent M; Garabet, Angela M

2013-01-01

Work Related Musculoskeletal Disorders (WMSDs) among office workers with intensive computer use is widespread and the prevalence of symptoms is growing. This randomized controlled trial investigated the effects of an office ergonomics training combined with a sit-stand workstation on musculoskeletal and visual discomfort, behaviors and performance. Participants performed a lab-based customer service job for 8 h per day, over 15 days and were assigned to: Ergonomics Trained (n = 11) or Minimally Trained (n = 11). The training consisted of: a 1.5-h interactive instruction, a sit/stand practice period, and ergonomic reminders. Ergonomics Trained participants experienced minimal musculoskeletal and visual discomfort across the 15 days, varied their postures, with significantly higher performance compared to the Minimally Trained group who had a significantly higher number of symptoms, suggesting that training plays a critical role. The ability to mitigate symptoms, change behaviors and enhance performance through training combined with a sit-stand workstation has implications for preventing discomforts in office workers. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Subjective health complaints and psychosocial work environment among university personnel.

PubMed

Moen, B E; Wieslander, G; Bakke, J V; Norbäck, D

2013-01-01

Questionnaires are often used to study health problems in working populations. An association between self-reported symptoms and psychosocial strain has been suggested, but results from such studies are difficult to interpret, as a gender difference might be present. The knowledge in this area is not clear. To compare the prevalence of subjective health symptoms and their relation to psychosocial work strain among men and women in different age groups, all working as university staff. A cross-sectional survey was carried out among university personnel. The questionnaire included a subjective health complaint inventory consisting of 29 items about subjective somatic and psychological symptoms experienced during the last 30 days and psychosocial work factors. Regression analyses were performed. In total, 172 (86%) of 201 eligible employees participated. Women had a higher prevalence of musculoskeletal symptoms than men. Significant differences were found between the genders for headaches, neck pain and arm pain. There was a significant relationship between musculoskeletal symptoms and work strain for both genders. This was found for both men and women below 40 years and among men above the age of 40. No significant difference was found between genders regarding pseudoneurological, gastrointestinal, allergic and flu-like symptoms. More female than male university personnel reported musculoskeletal symptoms. The musculoskeletal symptoms were associated with high work strain in both genders, but, for women, this was limited to employees under the age of 40. The cause of this gender difference is unknown.

Survey of faulty postures and associated factors among Chinese adolescents.

PubMed

Cho, Chiung-Yu

2008-03-01

This study investigates the prevalence of common faulty postures among adolescents and identify if significant relationships existed among the number of faulty postures, psychologic distress, and musculoskeletal symptoms. The Musculoskeletal Questionnaire and Chinese Health Questionnaire were randomly distributed to 300 high school students in the Tainan area. On-campus postural screening, which included digital photography, manual muscle tests, and flexibility tests, was also performed. Two hundred eighty-seven participants completed all of the evaluations. The most common faulty posture was uneven shoulder level (36%), followed by forward head posture (25%). There was a sex difference between groups. The incidence of forward head posture for the male students was higher than that of the female students (P < .0001). In addition, the high psychologic distress group tended to have a higher prevalence of uneven shoulder height than that of the low psychologic distress group (P < .0001). As for the correlation analysis, the researchers did not find a high correlation among the scores of the faulty posture, psychologic distress, and musculoskeletal symptoms. The results of this study show that the incidence of faulty posture was high for the adolescent group, especially for the uneven shoulder level. Subjects' awareness about being assessed might decrease the incidence for some faulty posture. However, the relationships among the number of faulty postures, psychologic distress, and musculoskeletal symptoms were low. We suggest that there are multiple factors that might contribute to musculoskeletal symptoms; faulty posture could be one important factor that causes symptoms.

Concussion May Increase the Risk of Subsequent Lower Extremity Musculoskeletal Injury in Collegiate Athletes

PubMed Central

Herman, Daniel; Jones, Debi; Harrison, Ashley; Moser, Michael; Tillman, Susan; Farmer, Kevin; Pass, Anthony; Clugston, Jay; Hernandez, Jorge; Chmielewski, Terese

2016-01-01

Background Laboratory-based studies on neuromuscular control after concussion and epidemiological studies suggest that concussion may increase the risk of subsequent musculoskeletal injury. Objective The purpose of this study was to determine if athletes have an increased risk of lower extremity musculoskeletal injury after return-to-play from a concussion. Methods Injury data were collected from 2006–2013 for men’s football and women’s basketball, soccer, and lacrosse at a NCAA Division I university. Ninety cases in 73 athletes (52 Male, 21 Female) of in-season concussion with return-to-play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return-to-play was reviewed for time-loss injury. The same period was studied in up to two control athletes who were without a concussion within the prior year and were matched on sport, starting status, and position. Results Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (45/90 or 50%) compared to the non-concussed athletes (30/148 or 20%) (p < 0.01). The odds of sustaining a musculoskeletal injury were 3.39 times higher in the concussed athletes (95% CI = 1.90, 6.05; p < 0.01). Overall, the number of days lost due to injury was similar between concussed and non-concussed athletes (Median = 9 vs 15, p = 0.41). Conclusions The results of this study demonstrate a relationship between concussion and an increased risk of lower extremity musculoskeletal injury after return to play, and may have implications for current medical practice standards regarding the evaluation and management of concussion injuries. PMID:27544666

Concussion May Increase the Risk of Subsequent Lower Extremity Musculoskeletal Injury in Collegiate Athletes.

PubMed

Herman, Daniel C; Jones, Debi; Harrison, Ashley; Moser, Michael; Tillman, Susan; Farmer, Kevin; Pass, Anthony; Clugston, James R; Hernandez, Jorge; Chmielewski, Terese L

2017-05-01

Laboratory-based studies on neuromuscular control after concussion and epidemiological studies suggest that concussion may increase the risk of subsequent musculoskeletal injury. The purpose of this study was to determine if athletes have an increased risk of lower extremity musculoskeletal injury after return to play from a concussion. Injury data were collected from 2006 to 2013 for men's football and for women's basketball, soccer and lacrosse at a National Collegiate Athletic Association Division I university. Ninety cases of in-season concussion in 73 athletes (52 male, 21 female) with return to play at least 30 days prior to the end of the season were identified. A period of up to 90 days of in-season competition following return to play was reviewed for time-loss injury. The same period was studied in up to two control athletes who had no concussion within the prior year and were matched for sport, starting status and position. Lower extremity musculoskeletal injuries occurred at a higher rate in the concussed athletes (45/90 or 50 %) than in the non-concussed athletes (30/148 or 20 %; P < 0.01). The odds of sustaining a musculoskeletal injury were 3.39 times higher in the concussed athletes (95 % confidence interval 1.90-6.05; P < 0.01). Overall, the number of days lost because of injury was similar between concussed and non-concussed athletes (median 9 versus 15; P = 0.41). The results of this study demonstrate a relationship between concussion and an increased risk of lower extremity musculoskeletal injury after return to play, and may have implications for current medical practice standards regarding evaluation and management of concussion injuries.

Arm and neck pain in ultrasonographers.

PubMed

Claes, Frank; Berger, Jan; Stassijns, Gaëtane

2015-03-01

The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society.

[Rhabdomyolysis in a well-trained woman after unusually intense exercise].

PubMed

Larsen, Christian; Jensen, Mogens Pfeiffer

2014-06-16

A 35-year-old woman was acutely hospitalized with oedema of the upper limbs, reduced force, severe movement reduction and muscle pain in both upper extremities. Her symptoms started after three days of intense exercise doing kayaking and a lot of pull-ups in crossfit. Rhabdomyolysis is a syndrome, characterized by muscle necrosis. Usually there is a marked elevation of creatine kinase (CK) concentration with symptoms as described and myoglobinuria (dark coloured urine). After hard muscular work there will often be asymptomatic, but significant elevations in CK concentration, and in rare cases life-threatening rhabdomyolysis with electrolyte imbalances and acute kidney failure.

Primary (de novo) dedifferentiated liposarcoma in the extremities: a multi-institution Tohoku Musculoskeletal Tumor Society study of 18 cases in northern Japan.

PubMed

Okada, Kyoji; Hasegawa, Tadashi; Kawai, Akira; Ogose, Akira; Nishida, Jun; Yanagisawa, Michiro; Morita, Tetsuro; Tajino, Takahiro; Tsuchiya, Takashi

2011-09-01

Dedifferentiated liposarcomas usually occur in the retroperitoneal space and relatively rarely in the extremities. We identified 18 patients with primary dedifferentiated liposarcoma in the extremities from the files of Tohoku Musculoskeletal Tumor Society and analyzed demographics, histologic findings, treatments and prognostic factors. The average follow-up period was 58 months. The subjects were 12 men and 6 women with a mean age of 65 years. All tumors were in the thigh. Nine patients noticed a rapid enlargement of the long-standing tumor. Histologic subtypes of the dedifferentiated area were undifferentiated pleomorphic sarcoma (n = 12), osteosarcoma (n = 2), rhabdomyosarcoma (n = 2), leiomyosarcoma (n = 1) and malignant peripheral nerve sheath tumor (n = 1). In the patient with rhabdomyosarcoma-like dedifferentiated area, extensive necrosis was observed after the preoperative chemotherapy. One patient who underwent marginal excision developed a local recurrence, but inadequate surgical margin was not associated with a risk of local recurrence. Three patients had lung metastasis at initial presentation, and four other patients developed lung metastases during the follow-up period. The overall survival rate was 61.1% at 5 years. On univariate analyses, large size of the dedifferentiated area (>8 cm), high MIB-1-labeling index (>30%) for the dedifferentiated area and lung metastasis at initial presentation were significantly associated with poor prognosis. Primary dedifferentiated liposarcoma in the extremities predominantly occurred in the thigh and a rapid enlargement of long-standing tumors was a characteristic symptom. Although the local behavior of these tumors was less aggressive than that of retroperitoneal dedifferentiated liposarcomas, they had a relatively high metastatic potential.

Prevalence of and factors associated with musculoskeletal symptoms in the spine attributed to computer use in undergraduate students.

PubMed

Kanchanomai, Siriluck; Janwantanakul, Prawit; Pensri, Praneet; Jiamjarasrangsi, Wiroj

2012-01-01

This study aimed to investigate the 3-month prevalence of musculoskeletal symptoms at the spine attributed to computer use and to identify biopsychosocial factors associated with the prevalence in undergraduate students. Undergraduate students who studied at a public university in Thailand. A cross-sectional survey was conducted with a self-administered questionnaire delivered to 3,545 students. A total of 2,511 students (73.7%) returned the questionnaires. Cervical symptoms (22.3%) were the most frequently reported, followed by thoracic (11%) and lumbar symptoms (10.7%). Females, daily computer use greater than three hours and too-high keyboard's position were significantly associated with a high prevalence of cervical symptoms. A significant association was found between higher undergraduate year of the study and too-high keyboard's position and a high prevalence of thoracic symptoms. Higher undergraduate year of the study and daily computer use greater than three hours were significantly related to a high prevalence of lumbar symptoms. Better-than-normal mental health status was associated with a low prevalence of lumbar symptoms. Spinal symptoms are common among undergraduate students. Various factors were identified to be associated with high prevalence of spinal symptoms. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.

Workplace management of upper limb disorders: a systematic review.

PubMed

Dick, F D; Graveling, R A; Munro, W; Walker-Bone, K

2011-01-01

Upper limb pain is common among working-aged adults and a frequent cause of absenteeism. To systematically review the evidence for workplace interventions in four common upper limb disorders. Systematic review of English articles using Medline, Embase, Cinahl, AMED, Physiotherapy Evidence Database PEDro (carpal tunnel syndrome and non-specific arm pain only) and Cochrane Library. Study inclusion criteria were randomized controlled trials, cohort studies or systematic reviews employing any workplace intervention for workers with carpal tunnel syndrome, non-specific arm pain, extensor tenosynovitis or lateral epicondylitis. Papers were selected by a single reviewer and appraised by two reviewers independently using methods based on Scottish Intercollegiate Guidelines Network (SIGN) methodology. 1532 abstracts were identified, 28 papers critically appraised and four papers met the minimum quality standard (SIGN grading + or ++) for inclusion. There was limited evidence that computer keyboards with altered force displacement characteristics or altered geometry were effective in reducing carpal tunnel syndrome symptoms. There was limited, but high quality, evidence that multi-disciplinary rehabilitation for non-specific musculoskeletal arm pain was beneficial for those workers absent from work for at least four weeks. In adults with tenosynovitis there was limited evidence that modified computer keyboards were effective in reducing symptoms. There was a lack of high quality evidence to inform workplace management of lateral epicondylitis. Further research is needed focusing on occupational management of upper limb disorders. Where evidence exists, workplace outcomes (e.g. successful return to pre-morbid employment; lost working days) are rarely addressed.

A Study to Evaluate Genetic Predictors of Aromatase Inhibitor Musculoskeletal Symptoms (AIMSS) | Division of Cancer Prevention

Cancer.gov

E1Z11 is a study to determine whether certain genetic information can predict which breast cancer patients will discontinue treatment with AIs due to the development of musculoskeletal symptoms (MSS). Women with stage 1-111 breast cancer who are prescribed the aromatase inhibitor anastrozole as treatment may join. |

Prevalence of self-reported musculoskeletal pain symptoms among school-age adolescents: age and sex differences.

PubMed

Keeratisiroj, Orawan; Siritaratiwat, Wantana

2018-04-25

Non-specific musculoskeletal pain symptoms are common in adolescents and may differ between the sexes, and be related to age and daily activities. It is critical to examine the prevalence and frequency of symptoms in adolescent students who tend to have pain which interferes with their routine activities. This study aimed to explore the prevalence and frequency of self-reported musculoskeletal pain symptoms by age and sex, and we also examined the association of symptoms with routine activities of school-age adolescents by area of pain. A cross-sectional survey was conducted among Thai students aged 10-19 years. All 2,750 students were asked to report previous 7-day and/or 12-month pain using the Standardized Nordic Questionnaire (Thai version) in 10 body areas. Multivariable logistic regression adjusted for age and sex was used to analyze the association between daily activity and musculoskeletal pain symptoms. A total of 76.1% (n=2,093) of students reported experiencing pain in the previous 7 days, 73.0% (n=2,007) reported in the previous 12-month period and 83.8% (n=2,304) reported pain in both 7-day and 12-month periods. The most common pain area was from a headache, with other areas being neck and shoulders, in that order, for both periods of time. The prevalence of musculoskeletal pain was especially higher in older groups and females. Participants reported frequency of pain as "sometimes in different areas" ranging from 78.4% to 88% and severity of pain at 3.82±2.06 out of 10 (95% CI 3.74-3.91). Routine daily activities associated with symptoms of headache, neck, shoulders, and ankles or feet pain were computer use (head, OR=2.22), school bag carrying (neck, OR=2.05), school bag carrying (shoulder, OR=3.09), and playing sports (ankle or foot, OR=2.68). The prevalence of musculoskeletal pain symptoms was high in both the previous 7-day and 12-month periods, especially in females and older adolescents, although most of them sometimes experienced pain. Computer use and school bag carrying were associated with headache, neck and shoulder pain, while playing sports was related to symptoms of the foot and ankle. The prevalence of pain was high, particularly in the older and female groups. Although they experienced mild symptoms sometimes, the related daily activities leading to these symptoms should be closely noticed.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil.

PubMed

Lacerda, Eliana M; Nácul, Luis C; Augusto, Lia G da S; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-10-11

The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population.

The role of ultrasound in assessing musculoskeletal symptoms of systemic lupus erythematosus: a systematic literature review

PubMed Central

Md Yusof, Md Yuzaiful; Wakefield, Richard J.; Conaghan, Philip G.; Emery, Paul; Vital, Edward M.

2016-01-01

Abstract Objectives. Musculoskeletal symptoms are common in SLE and are associated with significant morbidity. However, assessing their nature can be challenging, with implications for treatment decisions and measuring response. US has been shown to be valid and reliable for the assessment of other inflammatory arthritides, but data in SLE are more limited. The objectives of this systematic literature review were to determine the characteristics of musculoskeletal US abnormalities in SLE and to evaluate the metric properties of US in the detection and quantification of musculoskeletal symptoms. Methods. We systematically searched the literature using the PubMed, Embase and Cochrane Library databases for studies using musculoskeletal US for assessing SLE. Studies were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies tool and for their metric qualities, including reliability and validity. Results. Nine studies were identified. Most studies investigated construct validity. Rates of abnormality were highly variable: synovitis and tenosynovitis were reported in 25–94% and 28–65% of patients, respectively; power Doppler and erosions were reported in 10–82% and 2–41% of patients, respectively. There was poor to moderate association between US abnormalities and disease activity indices and immunological findings. There was moderate to high risk of bias and there were concerns about applicability in most studies. Conclusion. US has potential value in the assessment of musculoskeletal symptoms in SLE. However, there is methodological variation between studies that may account for lack of consensus on US abnormalities. Studies that address these problems are required before US can used as an outcome measure in SLE. PMID:26447163

Nonoperative Management of Cervical Radiculopathy.

PubMed

Childress, Marc A; Becker, Blair A

2016-05-01

Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 to 54 years of age. Cervical radiculopathy most often stems from degenerative disease in the cervical spine. The most common examination findings are painful neck movements and muscle spasm. Diminished deep tendon reflexes, particularly of the triceps, are the most common neurologic finding. The Spurling test, shoulder abduction test, and upper limb tension test can be used to confirm the diagnosis. Imaging is not required unless there is a history of trauma, persistent symptoms, or red flags for malignancy, myelopathy, or abscess. Electrodiagnostic testing is not needed if the diagnosis is clear, but has clinical utility when peripheral neuropathy of the upper extremity is a likely alternate diagnosis. Patients should be reassured that most cases will resolve regardless of the type of treatment. Nonoperative treatment includes physical therapy involving strengthening, stretching, and potentially traction, as well as nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. Epidural steroid injections may be helpful but have higher risks of serious complications. In patients with red flag symptoms or persistent symptoms after four to six weeks of treatment, magnetic resonance imaging can identify pathology amenable to epidural steroid injections or surgery.

The effect of extremity strength training on fibromyalgia symptoms and disease impact in an existing multidisciplinary treatment program.

PubMed

Kas, Tamara; Colby, Megan; Case, Maureen; Vaughn, Dan

2016-10-01

The purpose of this study was to examine the effect of upper and lower body extremity strengthening exercise in patients with Fibromyalgia (FM) within an existing multidisciplinary treatment program. Patients between the ages of 18-65 with the medical diagnosis of FM. Comparative study design. The control and experimental group received the same multidisciplinary treatment except that the experimental group performed upper and lower extremity strengthening exercises. The Fibromyalgia Impact Questionnaire (FIQ) was administered at evaluation and discharge from the program in order to measure change in quality of life (QOL). Statistically significant changes in FIQ scores were found for both groups. The addition of extremity strengthening in the experimental group produced an average 4 points greater reduction in FIQ score, however, these results are not considered statistically significant. This study appears to validate the success of a multidisciplinary approach in treating patients with FM, with the possibility for further benefit with the addition of extremity strengthening. Copyright © 2016 Elsevier Ltd. All rights reserved.

Musculoskeletal Problems in Iranian Hand-Woven Shoe-Sole Making Operation and Developing Guidelines for Workstation Design.

PubMed

Veisi, H; Choobineh, A R; Ghaem, H

2016-04-01

Musculoskeletal disorders (MSDs) are among important health problems in working population. Because of performing difficult physical activities, hand-woven shoe-sole makers are at risk of developing various types of MSDs. To determine the prevalence of musculoskeletal symptoms in different body areas of hand-woven shoe-sole makers, assess workers' postures and workstations, evaluate ergonomic and individual factors associated with MSDs, and develop guidelines for designing hand-woven shoe-sole making workstation. In this cross-sectional study, the prevalence of MSDs symptoms and their risk factors were studied among 240 hand-woven shoe-sole makers. Working posture and workstations were ergonomically assessed as well. The data were collected through interviewing and using Nordic musculoskeletal questionnaire and by direct observation of posture using RULA method. Logistic regression analysis was used to determine risk factors associated with MSDs symptoms. The prevalence and severity of MSDs symptoms were high among the study population. Ergonomic factors including daily working time, working posture, and force exertion, as well as individual factors, such as age, job tenure, and education were significantly associated with MSDs symptoms. It seems that the majority of ergonomics shortcomings originate from poorly designed workstation. Some general guidelines for designing shoe-sole making workstation are presented.

Musculoskeletal disorders and stress among footwear industry workers.

PubMed

de Almeida, Larissa Brentini; Vieira, Edgar Ramos; Zaia, José Eduardo; de Oliveira Santos, Branca Maria; Lourenço, Américo Riccardi Vaccari; Quemelo, Paulo Roberto Veiga

2017-01-01

Manufacturing footwear requires intense manual labor and high repetitions with low variability in function that may lead to musculoskeletal disorders (MSD) symptoms and psychological stress. To evaluate a potential association between musculoskeletal disorders (MSD) and perceived stress among footwear industry workers. The Nordic General Questionnaire (NGQ) and the Perceived Stress Scale (PSS-10) were completed by 357 footwear industry workers. The association between MSD and perceived stress was evaluated using the Chi-Square test and Odds Ratios along with their 95% Confidence Interval (95% CI) were calculated. The twelve-month prevalence of MSD symptoms among the respondents was 66% (n = 236) and the symptoms were significantly associated with perceived stress (p = 0.002, OR: 10, 95% CI: 1.7 to 60.6). The seven-day prevalence of MSD symptoms was 33% and the symptoms were also significantly associated with perceived stress (p = 0.001, OR: 2.7, 95% CI:0.8 to 9.3). The association between perceived stress and MSD symptoms indicates a strong association between MSD symptoms and perceived stress levels. Considering that these problems are important determinants of worker's health, a combined approach to reduce both stress and MSD symptoms is necessary for prevention and health promotion in the footwear industry.

The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession.

PubMed

Bos, E H; Krol, B; Van Der Star, A; Groothoff, J W

2006-06-10

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.

Musculoskeletal manifestations of systemic lupus erythmatosus.

PubMed

Mahmoud, Khaled; Zayat, Ahmed; Vital, Edward M

2017-09-01

Imaging studies suggest potential changes to the classification and assessment of inflammatory musculoskeletal lupus. This is important because of the burden of disease but the potential for new targeted therapies. Using our current classification and treatment, musculoskeletal symptoms continue to impact significantly on quality of life and work disability. Ultrasound and MRI studies suggested that new approaches to the diagnosis, classification, and evaluation of these symptoms are needed. Many patients with pain but no synovitis have ultrasound-proven joint and tendon inflammation but would not qualify for clinical trials or score highly on disease activity instruments. MRI studies show that erosions are more common than previously thought and may have a different pathogenesis than RA. Immunology studies suggest differences from other autoimmune synovitis, with a complex role for type I interferons. A wide range of biologic therapies appear more consistently effective for arthritis than some other manifestations. Changes to the selection of patients for therapy and stratification using musculoskeletal imaging may offer new approaches to clinical trials and the routine care of systemic lupus erythematosus patients with inflammatory musculoskeletal symptoms. Outcomes may thereby be improved using existing therapies. There are significant knowledge gaps that must be addressed to achieve these potential improved outcomes.

Incidence of and risk factors for musculoskeletal symptoms in the neck and low-back during severe flooding in Bangkok in 2011.

PubMed

Sihawong, Rattaporn; Janwantanakul, Prawit; Pensri, Praneet

2012-07-01

To examine whether the incidences of neck and low-back symptoms were elevated during the severe floods that occurred in Bangkok, Thailand in 2011, and to explore flood-related risk factors for neck and low-back symptoms. Prospective cohort design. Severe flooding occurred in Bangkok and surrounding neighbourhoods between October and December, 2011. After the flood had subsided (January 2012), 377 healthy office workers, who were already taking part in a study on musculoskeletal symptoms, were asked about their contact with floodwater. Data were gathered from subjects, who had reported no neck and low-back symptoms at the end of September 2011 and who were affected by the flood. Two regression models for the outcomes of 3-month incidence of neck and low-back symptoms, respectively, were performed. Eighty-two percent of the subjects were affected by the flood. No flood-related factor was found to associate significantly with either neck or low-back symptoms. However, neck symptoms may be associated with commuting frequently through flooded areas, and low-back symptoms may be associated with the subjects' homes or workplaces being flooded. These findings indicate that more attention needs to be paid to the problem of musculoskeletal symptoms during flooding in urban areas, and that preventive measures are required.

[Occupation-specific illnesses in musicians].

PubMed

Schuppert, M; Altenmüller, E

1999-12-01

Performance-related disorders in musicians are most often caused by multiple risk factors. They are based on the chronic complex, rapid and forceful work that requires highest precision, as well as on poor ergonomic conditions and psychological strain. Predominantly, the musculo-skeletal system of the upper extremity and the spine is affected by acute or chronic pain syndromes and neurological disorders. Stage fright and psychological tension frequently generate somatoform disorders and may contribute to the chronification of physical disabilities in musicians. Depending on the individual characteristics, the actual professional activity and the specific instrument, the performance-related risk factors and disorders differ widely. Early and regular prevention clearly contributes to a reduction of medical problems in musicians.

Prevalence and Risk Factors for Musculoskeletal Pain in Keyboard Musicians: A Systematic Review.

PubMed

Amaral Corrêa, Leticia; Dos Santos, Luciano Teixeira; Nogueira Paranhos, Edmur Nelson; Minetti Albertini, Alfredo Ignacio; do Carmo Silva Parreira, Patrícia; Nogueira, Leandro Alberto Calazans

2018-04-26

To identify the prevalence and risk factors for musculoskeletal pain in keyboard musicians. Systematic review METHODS: A systematic review was conducted according to the MOOSE recommendations and it was registered with the PROSPERO database under registration number CRD42016042913. We included observational studies through the electronic databases PubMed, Scopus, ScienceDirect, Web of Science, Répertoire International de Littérature Musicale (RILM), Retrospective Index to Music Periodicals (RIPM), Scielo, and Google Scholar, with combinations of the keywords pianists, keyboard players, musculoskeletal pain, muscular disease, tendinitis, tendinopathy, observational, case-control, prevalence, and risk factors. Data from population, information about pain, and risk factors were extracted from studies that fulfilled the eligibility criteria. The methodological quality of the studies was classified through the Newcastle-Ottawa Scale. The risk of bias and quality of evidence was assessed using the GRADE system. Twelve articles (case-controls) were included for the qualitative synthesis. The quality of the studies was classified as fair (n = 6) and good (n = 6). Prevalence was observed between 25.8% and 77.0% of musculoskeletal pain among keyboard musicians, with a higher prevalence in wrists and hands (13.8%-65.8%), neck (9.8%-64.2%), and shoulders (9.8%-59.8%). The only consistent risk factor found in the 4 studies was being female, with OR ranging from 1.05-1.90. Age greater than 18 years; weekly training more than 20 hours; training for more than 60 minutes without a rest break; not having a habit of practicing sports; and playing despite the pain were also described as risks factors for musculoskeletal pain. It was not possible to perform the meta-analysis due to the heterogeneity of the studies. Keyboard musicians presented a high prevalence of musculoskeletal pain, especially in the upper extremity regions of the body. Female, ageing, playing behaviors, and sedentary lifestyle showed an increased likelihood to report musculoskeletal pain. Level II. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Steering disturbance rejection using a physics-based neuromusculoskeletal driver model

NASA Astrophysics Data System (ADS)

Mehrabi, Naser; Sharif Razavian, Reza; McPhee, John

2015-10-01

The aim of this work is to develop a comprehensive yet practical driver model to be used in studying driver-vehicle interactions. Drivers interact with their vehicle and the road through the steering wheel. This interaction forms a closed-loop coupled human-machine system, which influences the driver's steering feel and control performance. A hierarchical approach is proposed here to capture the complexity of the driver's neuromuscular dynamics and the central nervous system in the coordination of the driver's upper extremity activities, especially in the presence of external disturbance. The proposed motor control framework has three layers: the first (or the path planning) plans a desired vehicle trajectory and the required steering angles to perform the desired trajectory; the second (or the musculoskeletal controller) actuates the musculoskeletal arm to rotate the steering wheel accordingly; and the final layer ensures the precision control and disturbance rejection of the motor control units. The physics-based driver model presented here can also provide insights into vehicle control in relaxed and tensed driving conditions, which are simulated by adjusting the driver model parameters such as cognition delay and muscle co-contraction dynamics.

Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.

PubMed

Kuzma, Scott A; Doberstein, Scott T; Rushlow, David R

2013-01-01

To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. A 23-year-old male collegiate wrestler injured his neck in a wrestling tournament match and experienced pain, weakness, and numbness in his left upper extremity. He completed that match and 1 additional match that day with mild symptoms. Evaluation by a certified athletic trainer 6 days postinjury showed radiculopathy in the C7 distribution of his left upper extremity. He was evaluated further by the team physician, a primary care physician, and a neurosurgeon. Cervical spine injury, stinger/burner, peripheral nerve injury, spinal cord injury, thoracic outlet syndrome, brachial plexus radiculopathy. The patient initially underwent nonoperative management with ice, heat, massage, electrical stimulation, shortwave diathermy, and nonsteroidal anti-inflammatory drugs without symptom resolution. Cervical spine radiographs were negative for bony pathologic conditions. Magnetic resonance imaging showed evidence of T1-T2 disc herniation. The patient underwent surgery to resolve the symptoms and enable him to participate for the remainder of the wrestling season. Whereas brachial plexus radiculopathy commonly is seen in collision sports, a postfixed brachial plexus in which the T2 nerve root has substantial contribution to the innervation of the upper extremity is a rare anatomic variation with which many health care providers are unfamiliar. The injury sustained by the wrestler appeared to be C7 radiculopathy due to a brachial plexus traction injury. However, it ultimately was diagnosed as radiculopathy due to a T1-T2 thoracic intervertebral disc herniation causing impingement of a postfixed brachial plexus and required surgical intervention. Athletic trainers and physicians need to be aware of the anatomic variations of the brachial plexus when evaluating and caring for patients with suspected brachial plexus radiculopathies.

Musculoskeletal symptoms in pharmaceutical sales representatives.

PubMed

Sang, Katherine; Gyi, Diane; Haslam, Cheryl

2010-03-01

Musculoskeletal disorders (MSDs) are a leading cause of work-related ill health. Existing literature indicates that pharmaceutical sales representatives (PSRs) report a high prevalence of MSDs, possibly exacerbated by the nature of work (prolonged driving and manual handling). In addition, they experience difficulty in accessing occupational health services. To assess the prevalence of musculoskeletal symptoms and associated risk factors among PSRs in order to assist their occupational health management through raising risk awareness. A self-completed questionnaire distributed to 205 PSRs within a UK pharmaceutical company was used to assess the prevalence of musculoskeletal symptoms, psychosocial factors, work tasks undertaken and company car use. To assist understanding of work tasks and organizational factors, semi-structured interviews were undertaken with a sample of 12 key personnel. The questionnaire response rate was 68%. PSRs reported high mileage and 100% reported working from the car in a typical day. Forty-seven per cent reported both manual handling for > or = 4 h/day and 'often' or 'sometimes' working from the car. Fifty-seven per cent reported low back symptoms in the last 12 months. Interview data revealed issues relating to car choice, storage in the boot and working from the car, which should be considered when developing priorities for preventive management of MSDs. Musculoskeletal symptoms appear to be a problem for PSRs, with risk factors reported as prolonged driving, sitting in the car, working from the car and manual handling. Interventions to facilitate their occupational health management should focus on raising awareness of the risks of prolonged driving and working from the car.

Musculoskeletal symptoms amongst clinical radiologists and the implications of reporting environment ergonomics--a multicentre questionnaire study.

PubMed

Rodrigues, Jonathan C L; Morgan, Steven; Augustine, Katharine; Clague, Gavin; Pearce, Tim; Pollentine, Adrian; Wallis, Adam; Wilson, David; McCoubrie, Paul

2014-04-01

This multicentre study aimed to assess compliance of the reporting environment with best ergonomic practice and to determine the prevalence of musculoskeletal symptoms related to working as a radiologist. All 148 radiology trainees and consultants in 10 hospitals across the region were invited to complete a musculoskeletal symptoms and reporting ergonomics questionnaire. Best ergonomic reporting practice was defined, following literature review, as being able to alter the following: monitor, desk, chair and armrest height, chair back support, ambient light, and temperature. The frequency that these facilities were available and how often they were used was determined. One hundred and twenty-three out of 148 (83%) radiologists responded, and 38% reported radiology-associated occupational injury. Lower back discomfort was the commonest radiology associated musculoskeletal symptom (41%). Only 13% of those with occupational injury sought the advice of occupational health. No reporting environments conformed completely to best ergonomic practice. Where certain facilities were available, less than a third of radiologists made personal ergonomic adjustments prior to starting a reporting session. Radiologists who had good self-assessed knowledge of best ergonomic practice had significantly less back discomfort than those with poor self-assessed knowledge (P < 0.005). We demonstrated high prevalence of musculoskeletal symptoms amongst radiologists. Poor compliance of the reporting environment with best ergonomic practice, in combination with our other findings of a low level of ergonomic awareness, low rates of making ergonomic adjustments and seeking appropriate help, may be implicated. We hope this study raises awareness of this issue and helps prevent long-term occupational injury amongst radiologists from poor ergonomic practice.

Infant carrying methods: Correlates and associated musculoskeletal disorders among nursing mothers in Nigeria.

PubMed

Ojukwu, Chidiebele Petronilla; Anyanwu, Godson Emeka; Anekwu, Emelie Morris; Chukwu, Sylvester Caesar; Fab-Agbo, Chukwubuikem

2017-10-01

Infant carrying is an integral part of the mothering occupation. Paucity of data exists on its correlates and associated musculoskeletal injuries. In this study, factors and musculoskeletal injuries associated with infant carrying were investigated in 227 nursing mothers, using a structured questionnaire. 77.1% utilised the back infant carrying methods (ICM). Maternal comfort was the major factor influencing participants' (37.4%) choices of ICMs. Infant's age (p = .000) and transportation means (p = .045) were significantly associated with ICMs. Low back pain (82.8%) and upper back pain (74.9%) were the most reported musculoskeletal discomforts associated with ICMs, especially among women who utilised back ICM. Back ICM is predominantly used by nursing mothers. Impact statement Infant carrying has been associated with increased energy cost and biomechanical changes. Currently, there is a paucity of data on infant carrying-related musculoskeletal injuries. In this study, investigating factors and musculoskeletal injuries associated with infant carrying, the results showed that back infant carrying method is predominantly used by nursing mothers. Age of the infant and mothers' means of transportation were determinant factors of infant carrying methods. Among the several reported infant carrying-related musculoskeletal disorders, low back and upper back pain were the most prevalent, especially among women who utilised the back infant carrying method. There is need for women's health specialists to introduce appropriate ergonomic training and interventions on infant carrying tasks in order to improve maternal musculoskeletal health during the childbearing years and beyond. Further experimental studies on the effects of various infant carrying methods on the musculoskeletal system are recommended.

An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India

PubMed Central

Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

2015-01-01

Background: Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. Objectives: The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). Methods: The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Results: Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Conclusions: Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS. PMID:25658674

Association of Parental Awareness of Using Schoolbags with Musculoskeletal Symptoms and Carrying Habits of Schoolchildren

ERIC Educational Resources Information Center

Dianat, Iman; Karimi, Mohammad Ali

2014-01-01

The association between parental awareness of using schoolbags and the occurrence of musculoskeletal symptoms and carrying habits of children was investigated in a cross-sectional study in Tabriz, Iran. Data on 454 students aged 11-14 years and their parents (n = 358) were analyzed. The awareness of the recommended weight limit, appropriate method…

Musculoskeletal symptoms in patients with cryopyrin-associated periodic syndromes: a large database study.

PubMed

Houx, Laetitia; Hachulla, Eric; Kone-Paut, Isabelle; Quartier, Pierre; Touitou, Isabelle; Guennoc, Xavier; Grateau, Gilles; Hamidou, Mohamed; Neven, Bénédicte; Berthelot, Jean-Marie; Lequerré, Thierry; Pillet, Pascal; Lemelle, Irène; Fischbach, Michel; Duquesne, Agnès; Le Blay, Pierre; Le Jeunne, Claire; Stirnemann, Jérome; Bonnet, Christine; Gaillard, Dominique; Alix, Lilian; Touraine, Renaud; Garcier, François; Bedane, Christophe; Jurquet, Anne-Laure; Duffau, Pierre; Smail, Amar; Frances, Camille; Grall-Lerosey, Martine; Cathebras, Pascal; Tran, Tu Anh; Morell-Dubois, Sandrine; Pagnier, Anne; Richez, Christophe; Cuisset, Laurence; Devauchelle-Pensec, Valérie

2015-11-01

To determine the type and frequency of musculoskeletal symptoms at onset and during followup of cryopyrin-associated periodic syndromes (CAPS). We retrospectively recorded the articular and muscular symptoms of patients with CAPS followed up in French hospitals. Data were presented as frequencies or the median (range), and patient groups were compared using chi-square test, Fisher's exact test, and Mann-Whitney test. The study included 133 patients (33 children), 20 with familial cold autoinflammatory syndrome, 88 with Muckle-Wells syndrome, 22 with chronic infantile neurologic, cutaneous, articular syndrome, and 3 with unclassified CAPS. The median age was 35 years (range 0-78 years) at the time of the study, 1 year (range 0-41 years) at symptom onset, and 23 years (range 0-58 years) at diagnosis. The disease was sporadic in 17% of the patients. Cutaneous symptoms predominated at onset (77%), followed by articular symptoms (30%). The p.Thr348Met and p.Arg260Trp NLRP3 mutations were significantly associated with the presence and absence of articular symptoms at onset, respectively. During followup, 86% of the patients had musculoskeletal symptoms, 88% had arthralgia, and 58% had arthritis, but only 9% had joint destruction. Tendinopathies occurred in 21.5% of the patients, tender points in 16.5%, and myalgia in 33%. Only 3 patients had typical knee deformities. Radiographs were rarely obtained. Except for bone deformities, osteoarticular symptoms occurred at similar frequencies in the different CAPS phenotypes. Joint manifestations were frequent in all CAPS phenotypes. Bone deformities were rare. Musculoskeletal manifestations varied within given families but tended to worsen over time. © 2015, American College of Rheumatology.

Upper limb musculoskeletal complaints among technicians working in a diagnostic tuberculosis laboratory: two case reports.

PubMed

Wong, Joyce Y P; Chin, David; Fung, Henry; Li, Ann; Wong, Marcus M S; Kwok, Henry K H

2014-01-01

Upper limb musculoskeletal complaints are common among certain health professionals. We report two cases, both involving technicians working in a diagnostic tuberculosis laboratory in Hong Kong. A work process evaluation suggest that the need to repeatedly open and close small bottles, as well as to work for prolonged periods of time in confined areas, could be related to the workers' clinical presentation. The cases are also compatible with the diagnosis of repetitive strain injury (RSI) of the upper limb, but this term is not commonly used nowadays because of various definitional issues. A review of the various diagnostic issues in RSI is presented.

Upper Extremity Injuries in NASCAR Drivers and Pit Crew: An Epidemiological Study.

PubMed

Wertman, Gary; Gaston, R Glenn; Heisel, William

2016-02-01

Understanding the position-specific musculoskeletal forces placed on the body of athletes facilitates treatment, prevention, and return-to-play decisions. While position-specific injuries are well documented in most major sports, little is known about the epidemiology of position-specific injuries in National Association for Stock Car Automobile Racing (NASCAR) drivers and pit crew. To investigate position-specific upper extremity injuries in NASCAR drivers and pit crew members. Descriptive epidemiological study. A retrospective chart review was performed to assess position-specific injuries in NASCAR drivers and pit crew members. Included in the study were patients seen by a single institution between July 2003 and October 2014 with upper extremity injuries from race-related NASCAR events or practices. Charts were reviewed to identify the diagnosis, mechanism of injury, and position of each patient. A total of 226 NASCAR team members were treated between July 2003 and October 2014. Of these, 118 injuries (52%) occurred during NASCAR racing events or practices. The majority of these injuries occurred in NASCAR changers (42%), followed by injuries in drivers (16%), carriers (14%), jack men (11%), fuel men (9%), and utility men (8%). The majority of the pit crew positions are at risk for epicondylitis, while drivers are most likely to experience neuropathies, such as hand-arm vibration syndrome. The changer sustains the most hand-related injuries (42%) on the pit crew team, while carriers commonly sustain injuries to their digits (29%). Orthopaedic injuries in NASCAR vary between positions. Injuries in NASCAR drivers and pit crew members are a consequence of the distinctive forces associated with each position throughout the course of the racing season. Understanding these forces and position-associated injuries is important for preventive measures and facilitates diagnosis and return-to-play decisions so that each team can function at its maximal efficiency.

Searching for a Gulf War syndrome using cluster analysis.

PubMed

Everitt, B; Ismail, K; David, A S; Wessely, S

2002-11-01

Gulf veterans report medically unexplained symptoms more frequently than non-Gulf veterans did. We examined whether Gulf and non-Gulf veterans could be distinguished by their patterns of symptom reporting. A k-means cluster analysis was applied to 500 randomly sampled veterans from each of three United Kingdom military cohorts of veterans; those deployed to the Gulf conflict between 1990 and 1991; to the Bosnia peacekeeping mission between 1992 and 1997; and military personnel who were in active service but not deployed to the Gulf (Era). Sociodemographic, health variables and scores for ten symptom groups were calculated. The gap statistic indicated the five-group solution as one that provided a particularly informative description of the structure in the data. Cluster 1 consisted of low scores for all symptom groups. Cluster 2 had veterans with highest symptom scores for musculoskeletal symptoms and high scores for psychiatric symptoms. Cluster 3 had high scores for psychiatric symptoms and marginally elevated scores for the remaining nine groups symptom groups. Cluster 4 had elevated scores for musculoskeletal symptoms only and cluster 5 was distinguishable from the other clusters in having high scores in all symptom groups, especially psychiatric and musculoskeletal. The findings do not support the existence of a unique syndrome affecting a subgroup of Gulf veterans but emphasize the excess of non-specific self-reported ill health in this group.

Segmental Musculoskeletal Examinations using Dual-Energy X-Ray Absorptiometry (DXA): Positioning and Analysis Considerations

PubMed Central

Hart, Nicolas H.; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L.; Newton, Robert U.

2015-01-01

Musculoskeletal examinations provide informative and valuable quantitative insight into muscle and bone health. DXA is one mainstream tool used to accurately and reliably determine body composition components and bone mass characteristics in-vivo. Presently, whole body scan models separate the body into axial and appendicular regions, however there is a need for localised appendicular segmentation models to further examine regions of interest within the upper and lower extremities. Similarly, inconsistencies pertaining to patient positioning exist in the literature which influence measurement precision and analysis outcomes highlighting a need for standardised procedure. This paper provides standardised and reproducible: 1) positioning and analysis procedures using DXA and 2) reliable segmental examinations through descriptive appendicular boundaries. Whole-body scans were performed on forty-six (n = 46) football athletes (age: 22.9 ± 4.3 yrs; height: 1.85 ± 0.07 cm; weight: 87.4 ± 10.3 kg; body fat: 11.4 ± 4.5 %) using DXA. All segments across all scans were analysed three times by the main investigator on three separate days, and by three independent investigators a week following the original analysis. To examine intra-rater and inter-rater, between day and researcher reliability, coefficients of variation (CV) and intraclass correlation coefficients (ICC) were determined. Positioning and segmental analysis procedures presented in this study produced very high, nearly perfect intra-tester (CV ≤ 2.0%; ICC ≥ 0.988) and inter-tester (CV ≤ 2.4%; ICC ≥ 0.980) reliability, demonstrating excellent reproducibility within and between practitioners. Standardised examinations of axial and appendicular segments are necessary. Future studies aiming to quantify and report segmental analyses of the upper- and lower-body musculoskeletal properties using whole-body DXA scans are encouraged to use the patient positioning and image analysis procedures outlined in this paper. Key points Musculoskeletal examinations using DXA technology require highly standardised and reproducible patient positioning and image analysis procedures to accurately measure and monitor axial, appendicular and segmental regions of interest. Internal rotation and fixation of the lower-limbs is strongly recommended during whole-body DXA scans to prevent undesired movement, improve frontal mass accessibility and enhance ankle joint visibility during scan performance and analysis. Appendicular segmental analyses using whole-body DXA scans are highly reliable for all regional upper-body and lower-body segmentations, with hard-tissue (CV ≤ 1.5%; R ≥ 0.990) achieving greater reliability and lower error than soft-tissue (CV ≤ 2.4%; R ≥ 0.980) masses when using our appendicular segmental boundaries. PMID:26336349

Comparison of Two Types of Insoles on Musculoskeletal Symptoms and Plantar Pressure Distribution in a Work Environment: A Randomized Clinical Trial.

PubMed

Almeida, Josiane S; Vanderlei, Franciele M; Pastre, Eliane C; Martins, Rodrigo A D M; Padovani, Carlos R; Filho, Guaracy C

2016-06-01

The aim of the present study was to assess plantar pressure distribution and musculoskeletal symptoms following the use of customized insoles among female assembly line workers. The study included 29 female assembly line workers (age, 29.76 ± 5.79 years; weight, 63.79 ± 12.11 kg) with musculoskeletal symptoms who work predominantly while standing. The Nordic Musculoskeletal Questionnaire was administered to the study population. Plantar pressure was determined using a computerized plantar pressure feedback system. A control group (n=13) used ethylvinylacetate insoles (Podaly®) that were individually heat molded and heat glued. The intervention group (n=14) also used the insoles and a strip of the same material was added to the site of greatest plantar pressure as determined by the electronic feedback device. After five weeks, the plantar pressure data were collected again and the questionnaire was administered a second time. There was no significant difference between groups with regard to pain in any anatomic site. However, within each group the lumbar region exhibited a reduction in symptoms in the intervention group (P<0.05), and the feet exhibited a reduction in symptoms in both groups (P<0.05). Mean plantar pressure increased and plantar surface decreased in the intervention group (P<0.05). Insoles increased foot comfort in both groups. However, the added strip did not significantly modify either plantar pressure or other symptoms in female workers. © 2016 Marshfield Clinic.

Statin-associated muscle symptoms-Managing the highly intolerant.

PubMed

Backes, James M; Ruisinger, Janelle F; Gibson, Cheryl A; Moriarty, Patrick M

Musculoskeletal symptoms are the most commonly reported adverse effects associated with statin therapy. Yet, certain data indicate that these symptoms often present in populations with underlying musculoskeletal complaints and are not likely statin related. Switching statins or using lower doses resolves muscle complaints in most patients. However, there is a growing population of individuals who experience intolerable musculoskeletal symptoms with multiple statins, regardless of the individual agent or prescribed dose. Recent randomized, placebo-controlled trials enrolling highly intolerant subjects provide significant insight regarding statin-associated muscle symptoms (SAMS). Notable findings include the inconsistency with reproducing muscle complaints, as approximately 40% of subjects report SAMS when taking a statin but not while receiving placebo, but a substantial cohort reports intolerable muscle symptoms with placebo but none when on a statin. These data validate SAMS for those likely experiencing true intolerance, but for others, suggest a psychosomatic component or misattribution of the source of pain and highlights the importance of differentiating from the musculoskeletal symptoms caused by concomitant factors. Managing the highly intolerant requires candid patient counseling, shared decision-making, eliminating contributing factors, careful clinical assessment and the use of a myalgia index score, and isolating potential muscle-related adverse events by gradually reintroducing drug therapy with the utilization of intermittent dosing of lipid-altering agents. We provide a review of recent data and therapeutic guidance involving a focused step-by-step approach for managing SAMS among the highly intolerant. Such strategies usually allow for clinically meaningful reductions in low-density lipoprotein cholesterol and an overall lowering of cardiovascular risk. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Why most workers with occupational repetitive trauma do not file for workers' compensation.

PubMed

Rosenman, K D; Gardiner, J C; Wang, J; Biddle, J; Hogan, A; Reilly, M J; Roberts, K; Welch, E

2000-01-01

Despite the availability of no fault insurance for wage replacement and medical care costs, the majority of workers diagnosed with an occupational disease do not apply for workers' compensation. The objective of the study was to determine the reasons why workers diagnosed with work-related musculoskeletal disease did not apply for workers' compensation benefits. A cross-sectional study of 1598 individuals diagnosed with neck, upper extremity, and low back work-related musculoskeletal disease from April to June 1996 was performed. All individuals were interviewed over the telephone using a standardized questionnaire. The questionnaire included questions about the precipitating event; demographics; health limitations; mood; pain level; and attitudes toward their health care provider, fellow workers, management, work environment, and filing for workers' compensation. Whenever possible, standardized questions from previous surveys were used. The interviewed individuals with work-related musculoskeletal disease were reported by health care practitioners as required by the state of Michigan's occupational disease reporting law. Workers reported during 12 weeks in the spring of 1996 by a Michigan health care professional as having a neck, back, or upper extremity musculoskeletal disorder were eligible to participate. Among the 2703 reports received, 490 individuals could not be reached, 22 did not speak English, 12 had died or were too incapacitated by other medical conditions, and 581 refused. We interviewed 59% of all eligible workers and 73% of all workers who were reachable and capable of responding in English. Only 25% of workers diagnosed with musculoskeletal disease filed a workers' compensation claim. The factors significantly associated with filing a claim were (1) increased length of employment (> 21 years: odds ratio [OR], 3.01, 95% confidence interval [CI], 1.31 to 6.90); 11 to 20 years: OR, 2.34, 95% CI, 1.01 to 5.47; 6 to 10 years: OR, 1.76, 95% CI, 0.73 to 4.25; 1 to 5 years: OR, 2.36, 95% CI, 1.03 to 5.42; < 1 year: OR, 1.00; (2) lower annual income (< $40,000: OR, 1.75, 95% CI, 1.06 to 2.88 vs > or = $80,000: OR, 1.00); (3) workers' dissatisfaction with coworkers (OR, 1.76, 95% CI, 1.01 to 3.06); (4) physician restrictions on activity (OR, 2.16, 95% CI, 1.55 to 3.00); (5) type of physician providing treatment (specialist, including surgeon or orthopedist: OR, 3.63, 95% CI, 2.37 to 5.55); physical and occupational therapist: OR, 2.15, 95% CI, 1.35 to 3.43); family practitioner: OR, 1.33, 95% CI = 0.89 to 2.01; company physician: OR = 1.00); (6) off work > or = 7 days (OR, 14.85, 95% CI, 10.57 to 20.85); (7) decreased current health status (OR, 0.82, 95% CI, 0.70 to 0.96); and (8) increased severity of illness (OR, 1.24, 95% CI, 1.06 to 20.88). This study showed that only 25% of workers with a work-related musculoskeletal condition filed for workers' compensation and refutes the common perception that an individual with a work-related problem is likely to file a workers' compensation claim. The strongest predictors of who would file were those factors associated with the severity of the condition. Other factors were increasing length of employment, lower annual income, and worker dissatisfaction with coworkers. Our study population consisted mainly of unionized autoworkers, and our findings may not be generalizable to the total workforce.

Inter-rater Reliability of Three Musculoskeletal Physical examination Techniques Used to Assess Motion in Three Planes While Standing

PubMed Central

Prather, Heidi; Hunt, Devyani; Steger-May, Karen; Hayes, Marcie Harris; Knaus, Evan; Clohisy, John

2012-01-01

Objective The objective of the study was to measure the reliability between examiners of three basic maneuvers of the Total Body Functional Profile© physical examination test. The hypothesis was musculoskeletal health care providers of different disciplines could reliably use the three basic maneuvers as part of the musculoskeletal physical examination. Design A prospective observational study was conducted. Twenty-eight adult volunteers were measured on both the left and right side by two independent raters on a single occasion. Setting The subjects were recruited through advertisements placed by the orthopedic department at a tertiary university. Participants 28 volunteers were recruited and completed the study. The volunteers were between the ages of 18 and 51 years of age, had no symptoms in the lower extremity or spine, had no previous history of surgery or tumor involving the lower extremity, and no medical conditions that would preclude participation. Assessment On a single occasion, two examiners per one volunteer were blinded to their own and each others' measurements. Each examiner assessed the distance of frontal and sagittal plane lunge and angle of motion for transverse plane testing. Main Outcome Measurements Inter-rater agreement is expressed with intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). The difference between raters is reported with 95% CIs. Baseline demographics, UCLA, and Harris hip questionnaires were completed by all participants. Results The UCLA and Harris hip scores showed no significant activity restrictions or pain limitations in all participants. The inter-rater reliability for sagittal, frontal, and transverse plane matrix testing was good with ICCs of 0.86 (95% CI 0.77, 0.91), 0.90 (95% CI 0.84, 0.94), and 0.85 (95% CI 0.75, 0.91) respectively. The rater reliability between disciplines for transverse, sagittal and frontal plane matrix testing was good with ICCs of 0.89 (95% CI 0.80, 0.94), 0.88 (95% CI 0.79, 0.94), 0.90 (95% CI 0.81, 0.95). Conclusion The inter-rater reliability for three basic maneuvers of the Total Body Functional Profile© is good amongst musculoskeletal healthcare providers of different disciplines. These three maneuvers may be used consistently as part of the musculoskeletal physical examination. PMID:19627956

Inter-rater reliability of three musculoskeletal physical examination techniques used to assess motion in three planes while standing.

PubMed

Prather, Heidi; Hunt, Devyani; Steger-May, Karen; Hayes, Marcie Harris; Knaus, Evan; Clohisy, John

2009-07-01

The objective of the study was to measure the reliability between examiners of 3 basic maneuvers of the Total Body Functional Profile physical examination test. The hypothesis was musculoskeletal health care providers of different disciplines could reliably use the 3 basic maneuvers as part of the musculoskeletal physical examination. A prospective observational study was conducted. Twenty-eight adult volunteers were measured on both the left and right side by 2 independent raters on a single occasion. The subjects were recruited through advertisements placed by the orthopedic department at a tertiary university. Twenty-eight volunteers were recruited and completed the study. The volunteers were between the ages of 18 and 51 years of age, had no symptoms in the lower extremity or spine, had no previous history of surgery or tumor involving the lower extremity, and no medical conditions that would preclude participation. On a single occasion, 2 examiners per 1 volunteer were blinded to their own and each others' measurements. Each examiner assessed the distance of frontal and sagittal plane lunge and angle of motion for transverse plane testing. Inter-rater agreement is expressed with intraclass correlation coefficients (ICCs) and corresponding 95% confidence intervals (CIs). The difference between raters is reported with 95% CIs. Baseline demographics, University of California Los Angeles (UCLA), and Harris hip questionnaires were completed by all participants. The UCLA and Harris hip scores showed no significant activity restrictions or pain limitations in all participants. The inter-rater reliability for sagittal, frontal, and transverse plane matrix testing was good with ICCs of 0.86 (95% CI 0.77-0.91), 0.90 (95% CI 0.84-0.94), and 0.85 (95% CI 0.75-0.91), respectively. The rater reliability between disciplines for transverse, sagittal, and frontal plane matrix testing was good with ICCs of 0.89 (95% CI 0.80-0.94), 0.88 (95% CI 0.79-0.94), and 0.90 (95% CI 0.81-0.95), respectively. The inter-rater reliability for 3 basic maneuvers of the Total Body Functional Profile is good among musculoskeletal health care providers of different disciplines. These 3 maneuvers may be used consistently as part of the musculoskeletal physical examination.

Risk Factors for Neck and Upper Extremity Disorders among Computers Users and the Effect of Interventions: An Overview of Systematic Reviews

PubMed Central

Andersen, Johan H.; Fallentin, Nils; Thomsen, Jane F.; Mikkelsen, Sigurd

2011-01-01

Background To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. Methodology/Principal Findings PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Conclusions/Significance Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented. PMID:21589875

Upper extremity musculoskeletal pain among office workers in three Spanish speaking-countries: findings from the CUPID study

PubMed Central

Campos-Fumero, Adriana; Delclos, George L.; Douphrate, David I.; Felknor, Sarah A.; Vargas-Prada, Sergio; Serra, Consol; Coggon, David; Gimeno, David

2016-01-01

Objectives To estimate the prevalence and incidence of upper extremity musculoskeletal pain (UEMP) and related disability among office workers in Costa Rica, Nicaragua and Spain. Methods Data from the multinational CUPID study on 947 (93%) participants at baseline with 90% follow-up after 12 months. logistic regression was used to estimate the associations (odds ratios [ORs] and corresponding 95% confidence intervals [95%CIs]) between country and six outcomes: baseline prevalence of (1) UEMP in past 12 months, (2) UEMP in past month, and (3) disabling UEMP in past month; (4) incidence of new UEMP at follow-up; (5) incidence of new disabling UEMP at follow-up; and (6) persistence of UEMP at follow-up, after adjustment for sociodemographic, job-related and health-related covariates. Results Baseline prevalence of UEMP in the past month was higher in Costa Rica (53.6%) (OR=1.89; 95% CI: 1.36-2.62), and Nicaragua (51.9%) (OR=1.74; 95% CI: 1.28-2.35) than in Spain (38.4%). Compared to Spain (33.2%), the incidence of new UEMP was 50.4% in Costa Rica (OR=2.04; 95% CI: 1.34-3.12), and 60.2% in Nicaragua (OR=3.04; 95% CI: 2.06-4.50). The incidence of disabling UEMP was higher in Nicaragua (OR=2.57; 95% CI: 1.50-4.41) and Costa Rica (OR=2.16; 95% CI: 1.22-3.84) when compared to Spain. Conclusion Prevalence of UEMP was approximately 2-fold higher and its incidence 2- to 3-fold higher in Costa Rica and Nicaragua as compared with Spain. Between-country differences were only partially explained by the covariates analyzed. Research is needed to explore other aspects of work and cultural attributes that might explain the residual differences in UEMP. PMID:26972870

Effect of informal employment on the relationship between psychosocial work risk factors and musculoskeletal pain in Central American workers.

PubMed

Gimeno Ruiz de Porras, David; Rojas Garbanzo, Marianela; Aragón, Aurora; Carmenate-Milián, Lino; Benavides, Fernando G

2017-09-01

The constant increase on the psychosocial demands experienced at work seems to contribute to the increase in health problems such as musculoskeletal pain (MSP). This association may be especially important in low-income and middle-income countries, where there is a large proportion of informal workers among whom there is little research. We analysed the association between psychosocial work risk factors and MSP among formal and informal workers using the First Central American Survey of Working Conditions and Health. This is a representative sample (n=12 024) of the economically active population of the six Spanish-speaking countries of Central America. Prevalence ratios (PR) and corresponding 95% CIs from Poisson regression models were used to estimate the association between psychosocial work risk factors and the MSP. Compared with formal workers, informal workers reported higher prevalence of MPS in the body regions analysed (ie, cervicodorsal, lumbosacral, upper extremities) and higher exposure to psychosocial work risk factors. However, on the whole, the associations between the exposure to psychosocial work risk factors and the prevalence of MSP were similar for both formal and informal workers. Only the association between exposure to high demands and MSP in the upper extremities was higher (p=0.012) among formal (PR=1.69, 95% CI 1.46 to 1.96) than among informal workers (PR=1.40; 95% CI 1.30 to 1.51). Exposure to adverse levels of psychosocial work risk factors is associated with higher prevalence of MPS among both formal and informal workers. However, the role of employment informality in this association is complex and requires further examination. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Characterization of Microgravity Effects on Bone Structure and Strength Using Fractal Analysis

NASA Technical Reports Server (NTRS)

Acharya, Raj S.; Shackelford, Linda

1996-01-01

Protecting humans against extreme environmental conditions requires a thorough understanding of the pathophysiological changes resulting from the exposure to those extreme conditions. Knowledge of the degree of medical risk associated with the exposure is of paramount importance in the design of effective prophylactic and therapeutic measures for space exploration. Major health hazards due o musculoskeletal systems include the signs and symptoms of hypercalciuria, lengthy recovery of lost bone tissue after flight, the possibility of irreversible trabecular bone loss, the possible effect of calcification in the soft tissues, and the possible increase in fracture potential. In this research, we characterize the trabecular structure with the aid of fractal analysis. Our research to relate local trabecular structural information to microgravity conditions is an important initial step in understanding the effect of microgravity and countermeasures on bone condition and strength. The proposed research is also closely linked with Osteoporosis and will benefit the general population.

Musculoskeletal Load in and Highly Repetitive Actions of Animal Facility Washroom Employees

PubMed Central

Kiermayer, Claudia; Hoehne-Hückstädt, Ulrike M; Brielmeier, Markus; Brütting, Mark; Ellegast, Rolf; Schmidt, Jörg

2011-01-01

Regular work tasks in the washroom of laboratory animal facilities include cleaning of cages and bottles and handling of chow and bedding. These operations largely are carried out by hand. We quantitatively determined the musculoskeletal load on the trunk and upper limbs of washroom employees in an animal facility with a holding capacity of 35,000 rodent cages by using a computer-assisted, quantitative, recording, and long-term analysis (CUELA) system, which volunteers wore during routine work. Parallel video recording allowed exact assignment of each movement of body and limbs to the data recorded by the sensors. For the most part, trunk movements were unassociated with risk of injury. Evaluation of upper limb movements by CUELA indicated elevated burden on shoulder, elbows, and wrists due to the high repetitiveness and range of movements and postures. However, after additional work factors like low effort and the presence of micropauses were taken into account, workers were not at risk for the development of musculoskeletal disorders of the upper limbs. Handling bottles, chow, and bedding and maneuvering trolleys that entailed greater musculoskeletal loads did not yield evidence of overstraining, because the actions typically were executed alternately and were of short duration during daily shifts. The results represent quantitative information on the musculoskeletal load of regular washroom operations in a laboratory animal facility. These data provide the basis for ergonomic redesign of operations and implementation of automation for highly repetitive movements. PMID:22330713

Decision-making in job attendance within health care--a qualitative study.

PubMed

Tveten, K M; Morken, T

2016-04-01

Musculoskeletal complaints are considered a major cause of sickness absence, particularly in areas such as the health sector. However, little is known about the personal decision-making process for self-certified sickness absence. To explore female health care workers' thoughts and experiences about work attendance when experiencing musculoskeletal symptoms. A qualitative study using individual, semi-structured, in-depth interviews with eight female health care workers was performed. Questions were related to factors influencing the decision to attend work and decision-making when facing the dilemma of attending work when experiencing musculoskeletal symptoms. The data were analysed according to the systematic text condensation. Subjects reported a high threshold before calling in sick. Self-certified sickness absence was not a strategy for coping with musculoskeletal symptoms as participants chose to be physically active and work part-time rather than taking sickness absence. Making decisions about attending work fostered conflicting norms, as women faced a dilemma between feeling guilt towards colleagues and patients and taking care of their own health. The findings highlight the complexity of managing work when experiencing musculoskeletal symptoms, and the dilemmas faced by those affected. The importance of work environment factors and the fact that some women feel compelled to work part-time in order to prioritize their own health require further consideration. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Online Health Information Seeking in Hand and Upper Extremity Surgery.

PubMed

Özkan, Sezai; Mellema, Jos J; Nazzal, Adam; Lee, Sang-Gil; Ring, David

2016-12-01

Information gathering is a key component of shared decision making and has a measurable effect on treatment decisions. Access to health information might improve quality of care in hand surgery. Our purpose was to identify socio-demographic, condition-related, and psychosocial factors associated with online information-seeking behavior in patients with hand and upper-extremity conditions. From June 2015 to February 2016, we enrolled 134 patients with an upper-extremity condition who presented to an outpatient hand surgery office at an urban level I trauma center in this cross-sectional study. Participants provided socio-demographic information and completed online questionnaires assessing their online information-seeking behavior, pain intensity, symptoms of depression, and pain interference, and an upper extremity-specific, patient-reported outcome measure. A total of 57 patients (43%) sought information regarding their condition online before their visit. Compared with patients with no online information-seeking behavior, patients who sought information online were more educated. Psychosocial and condition-related factors were not associated with online information seeking. In multivariable analysis, education in years and involvement of the dominant upper limb were independently associated with online information-seeking behavior. Education in years and involvement of the dominant upper limb were independently associated with online information-seeking behavior but psychosocial and condition-related factors were not. As health information seeking is becoming an integral part of the modern day clinical experience, efforts to make online information more appealing and useful to people of all education levels are merited. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Musculoskeletal alterations associated factors physical and environmental in dental students.

PubMed

Fals Martínez, Juntzo; González Martínez, Farith; Orozco Páez, Jennifer; Correal Castillo, Sandra Patricia; Pernett Gómez, Cindy Vanessa

2012-12-01

To describe the musculoskeletal disorders and association with physical and environmental in students of Dentistry. Cross sectional study. Simple random sampling was conducted obtaining a proportional sample of 182 students per semester. Collecting information from physical and environmental exposures related to different clinical practice and this was assessed by a structured survey questionnaire type. The valuation muscle was performed by visual analysis with Scan-test. To assess factors related to working position, the instrument was used RULA. For the analysis of the association were used odds ratios with confidence intervals of 95%. For the multivariate analysis using logistic regression. 58.2% of students had pain tenderness in upper trapezius and 45.6% in area cervical. Lateral movements in the cervical found pain in 35.7%, with the bending cervical 35.1% related to all these factors own dental practice and not to other factors external. The onset of muscle pain in this population is influenced by multiple variables, most of them, related to dental practice of students to interact with each other can trigger symptoms at neck and back.

Concussion Frequency Associates with Musculoskeletal Injury in Retired NFL Players.

PubMed

Pietrosimone, Brian; Golightly, Yvonne M; Mihalik, Jason P; Guskiewicz, Kevin M

2015-11-01

Concussion is commonly associated with immediate and persistent alterations in motor function affecting postural control and gait. Patients with lower extremity joint injury have demonstrated functional alterations in the cerebral cortex, suggesting that musculoskeletal injury may be linked to alterations in brain function. Therefore, we examined the associations between concussion frequency and lower extremity musculoskeletal injury sustained during professional careers of National Football League (NFL) players in a cross-sectional study. An inclusive health history survey was mailed to 3647 NFL players who retired during 1930-2001. Respondents reported total concussion frequency (zero, one, two, or three or more) and presence (yes/no) of specific knee and ankle musculoskeletal injury during their NFL career. Separate logistic regression models were used to estimate associations between concussion frequency and each musculoskeletal injury type, adjusting for number of years played in the NFL, body mass index while playing in the NFL, and playing position. Data from 2429 players (66.6% response rate) were available for analysis. Nearly 61% reported experiencing a concussion while competing in the NFL. Meniscal tear was the most commonly reported musculoskeletal injury (32%). Compared with NFL players who did not sustain a concussion, retired NFL players with one, two, or three or more concussions had between 18% and 63%, 15% and 126%, and 73% and 165% higher odds of reporting various musculoskeletal injuries, respectively. A history of concussions was associated with a history of musculoskeletal injuries during NFL careers. These data suggest that a higher number of concussions is linked with higher odds of reporting a musculoskeletal injury.

Musculoskeletal disorders among Thai women in construction-related work.

PubMed

Hanklang, Suda; Kaewboonchoo, Orawan; Silpasuwan, Pimpan; Mungarndee, Suriyaphun S

2014-03-01

A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorder symptoms and its risk factors among women rebar workers. A simple random sampling method was used and data were collected by face-to-face interview and ergonomic assessment from February to March 2011. A total of 272 women rebar workers with at least 6 months' job experience participated in this study. The findings revealed that 57.7% of workers reported musculoskeletal disorder symptoms with low back and shoulders as the most common body parts affected (46.0%). Multiple logistic regression analysis indicated 2 variables that are significantly associated with musculoskeletal disorders: prolonged working hours (adjusted odds ratio = 7.63; 95% confidence interval = 2.06-28.31) and awkward posture (adjusted odds ratio = 43.79; 95% confidence interval = 17.09-112.20). The high prevalence of musculoskeletal disorders among women rebar workers suggests that an appropriate ergonomic workstation design and ergonomic training for women rebar workers are necessary.

Psychosocial Risk Factors and Musculoskeletal Symptoms among White and Blue-collar Workers at Private and Public Sectors

PubMed Central

2014-01-01

Objectives The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public). Methods Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses. Results According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers’ categories (p < 0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p < 0.01), and for both epicondyles (p < 0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p < 0.01; left, p = 0.05). There was no significant association in the report of symptoms across the groups (p > 0.05). Conclusion This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers’ group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors. PMID:25854836

Psychosocial Risk Factors and Musculoskeletal Symptoms among White and Blue-collar Workers at Private and Public Sectors.

PubMed

Januario, Leticia B; Batistao, Mariana V; Coury, Helenice Jcg; Oliveira, Ana Beatriz; Sato, Tatiana O

2014-01-01

The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public). Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses. According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers' categories (p < 0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p < 0.01), and for both epicondyles (p < 0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p < 0.01; left, p = 0.05). There was no significant association in the report of symptoms across the groups (p > 0.05). This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers' group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors.

Prevalence and potential determinants of musculoskeletal disease symptoms among care workers in long-term care facilities in South Korea.

PubMed

Park, Myung-Sook; Yu, Mi; Yu, Su-Jeong; Kang, Kyung-Ja; Seo, Hyun-Mi

2014-07-01

The purpose of this study was to investigate the degree and influencing factors of musculoskeletal disease symptoms among care workers in long-term care facilities in South Korea. Participants in this cross-sectional study were 265 care workers in 15 long-term care facilities. Data were collected between 1 and 27 August 2011, using the Korea Occupational Safety and Health Agency (KOSHA) code H-30-2003 and analyzed using logistic regression with SPSS ver. 18.0. Of the care workers, 88.7% had pain in at least one of the six body parts. The highest prevalence of musculoskeletal disease symptoms was in the lower back and legs. Among the organizational factors, there were significant differences in neck pain by work shift and patient grade. Neck pain was more severe in the 8 h shift group than 12-24 h shift group. Care workers caring for patients who were classified in the first patient grade of long-term care insurance had 4.73 times more complaints of musculoskeletal symptoms in the neck, 9.54 times (95% confidence interval [CI] = 3.37-27.02) in the hand and wrist, 4.37 times (95% CI = 1.59-12.03) in the lower back, and 2.96 times (95% CI: 1.17-7.51) in the leg and foot. To prevent and manage musculoskeletal disease symptoms, activities and the intensity of work should be arranged systematically and planned, and the improvement of organizational factors such as appropriate assignment by patients' severity is considered. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients.

PubMed

Yi, Xiao-lei; Chen, Jie; Li, Jia; Feng, Liang; Wang, Yan; Zhu, Jia-An; Shen, E; Hu, Bing

2014-03-01

To investigate the incidence and risk factors for peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer. With the widespread use of peripherally inserted central venous catheters, peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer leads to increasing morbidity and mortality. It is very important to further explore the incidence and risk factors for peripherally inserted central venous catheters-related venous thrombosis. Consecutive patients with cancer who were scheduled to receive peripherally inserted central venous catheters, between September 2009 and May 2012, were prospectively studied in our centre. They were investigated for venous thrombosis by Doppler sonography three times a day within 30 days after catheter insertion. Univariable and multivariable logistic regressions' analyses were performed to identify the risk factors for peripherally inserted central venous catheters-related thrombosis. A total of 89 patients with cancer were studied in our research. Of these, 81 patients were followed up within one month. The mean interval between catheter insertion and the onset of thrombosis was 12.45 ± 6.17 days. The multivariable analyses showed that chemotherapy history, less activities and diabetes were the key risk factors for thrombosis. Peripherally inserted central venous catheters-related upper extremity venous thrombosis had high incidence rate, and most cases had no significant symptoms. The history of chemotherapy, less activities and diabetes were found to be the key risk factors. It should be routinely scanned in high-risk patients every 3-5 days after catheter insertion, which would then find blood clots in time and reduce the incidence of pulmonary embolism. Risk factors associated with peripherally inserted central venous catheters-related upper extremity venous thrombosis are of critical importance in improving the quality of patients' life. It is very important to grasp the indications to reduce the incidence rate of peripherally inserted central venous catheters-related upper extremity venous thrombosis. © 2013 John Wiley & Sons Ltd.

Assessment of musculoskeletal impairment in head and neck cancer patients.

PubMed

Ghiam, Michael K; Mannion, Kyle; Dietrich, Mary S; Stevens, Kristen L; Gilbert, Jill; Murphy, Barbara A

2017-07-01

This study aims to describe the types of musculoskeletal impairment in head and neck cancer survivors and to evaluate objective and subjective measures of musculoskeletal impairment and identify areas of need in future studies. This is a cross-sectional pilot study of 29 head and neck cancer patients who were treated with resection and reconstruction. Subjective measures of musculoskeletal impairment (Neck Disability Index, Shoulder Pain and Disability Index, Vanderbilt Head and Neck Symptom Survey, General Symptom Survey) were collected and compared to objective measures (Cervical Range of Motion Device, Inter-incisal Distance). Digital photography was used to assess the severity of postural abnormalities. Findings were summarized using descriptive statistical and graphical methods. The majority of patients in this cohort suffered from neck disability (69%). Thirty-five percent of patients had shoulder pain and disability. Cervical range of motion deficits were observed in all directions. Inter-incisal distance averaged 33.4 mm and inversely correlated with self-reported jaw and trismus symptoms. Digital photography identified shoulder misalignment in 93% of subjects, head tilt in 89% of subjects, and postural deviation in 68% of subjects. Musculoskeletal impairment is a significant side effect in head and neck cancer survivors that results in chronic neck pain, shoulder disability, trismus, and postural deficits. Tools to describe postural deficits are needed.

Cumulative IT Use Is Associated with Psychosocial Stress Factors and Musculoskeletal Symptoms.

PubMed

So, Billy C L; Cheng, Andy S K; Szeto, Grace P Y

2017-12-08

This study aimed to examine the relationship between cumulative use of electronic devices and musculoskeletal symptoms. Smartphones and tablet computers are very popular and people may own or operate several devices at the same time. High prevalence rates of musculoskeletal symptoms associated with intensive computer use have been reported. However, research focusing on mobile devices is only just emerging in recent years. In this study, 285 persons participated including 140 males and 145 females (age range 18-50). The survey consisted of self-reported estimation of daily information technology (IT) exposure hours, tasks performed, psychosocial stress factors and relationship to musculoskeletal discomfort in the past 12 months. Total IT exposure time was an average of 7.38 h (±5.2) per day. The psychosocial factor of "working through pain" showed the most significant association with odds ratio (OR) ranging from 1.078 (95% CI = 1.021-1.138) for elbow discomfort, to 1.111 (95% CI = 1.046-1.180) for shoulder discomfort. Desktop time was also significantly associated with wrist/hand discomfort (OR = 1.103). These findings indicate only a modest relationship but one that is statistically significant with accounting for confounders. It is anticipated that prevalence rates of musculoskeletal disorders would rise in the future with increasing contribution due to psychosocial stress factors.

Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review

PubMed Central

Onate, James A.; Everhart, Joshua S.; Clifton, Daniel R.; Best, Thomas M.; Borchers, James R.; Chaudhari, Ajit M.W.

2016-01-01

Objective A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. Data Sources A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Main Results Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5–6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2–18.4; P < 0.05), hip external: internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = −0.339, P = 0.008). Conclusions Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury. PMID:26978166

[Epidemiology of illnesses and musculoskeletal disorders in grocery stores and catering].

PubMed

Bonzini, Matteo; Battevi, Natale; Stucchi, Giulia; Vitelli, Nora

2014-01-01

Large scale retail industry and catering industry are characterized by the widespread presence of several risk factors of work-related musculoskeletal disorders (WMSD): repetitive movements, incongruous postures and manual handling tasks. We reviewed current epidemiological evidence related to musculoskeletal disorders within these two sectors, distinguishing between symptoms and clinically documented disorders. In retail industry cashier is the most investigated figure, regarding upper limbs disorders as a consequence of repetitive tasks. In the catering sector there are few studies, mostly focused only on the job as a cook. The majority of studies showed a high prevalence of WMSD and, to a lesser extent, a high frequency ofmusculoskeletal alterations; suggesting the presence of a not negligible risk. These findings, however, are affected by a number of methodological limitations: they derive from cross-sectional studies, are based on voluntary self-selected workers, are focused on not unequivocally defined health outcomes, and are usually lacking a proper comparison. with the prevalence in less exposed/reference working groups. In order to achieve an effective control of the workers' risk, it is therefore necessary to design and conduct prospective studies that compare the risk of developing disorders and/or diseases in workers exposed to different levels of biomechanical load. It appears essential to involve occupational physicians in active health surveillance programs in order to identify critical areas and to develop effective preventive measures.

[Prevalence of fibromyalgia in diabetes mellitus and obesity].

PubMed

Patucchi, Emanuele; Fatati, Giuseppe; Puxeddu, Adolfo; Coaccioli, Stefano

2003-04-01

To determine the prevalence of fibromyalgia in diabetes mellitus and obesity, 121 consecutive patients have been observed: 27 with obesity (6 males and 21 females; mean age 57 years, range 20-57; mean body mass index [BMI] 34); 88 with type 2 diabetes mellitus (T2DM; 40 males and 48 females; mean age 63 years, range 44-78; mean BMI 28.8; mean glycated haemoglobin [HbA1c] in the last year 8.3%); 6 with type 1 diabetes mellitus (T1DM; 2 males and 4 females; mean age 52 years, range 26-76; mean BMI 24.5; mean HbA1c < 7%). An original questionnaire has been proposed (answer yes/not) as follows: 1) chronic (more than 3 months) and diffuse musculoskeletal pain; 2) sleep disturbances; 3) generalized fatigue; 4) paresthesias at the extremities; 5) swollen impression at hands and feet; 6) symptoms referred to irritable bowel syndrome; 7) headache; 8) symptoms change related with environmental climatic variations and/or exercise. A chronic and diffuse musculoskeletal pain has been reported by 62% of patients as well as in 9% of patients 11/18 positive tender points have been documented. In the patients with a BMI less that 26 the diagnosis of fibromyalgia was negative. Our data seem to reveal the presence of a significant clinical association between obesity, diabetes mellitus and fibromyalgia.

Comparison of the BackJoy SitSmart Relief and Spine Buddy LT1 H/C Ergonomic Chair Supports on Short-Term Neck and Back Pain.

PubMed

Ward, John; Coats, Jesse

2017-01-01

The purpose of this study was to perform a needs assessment to determine whether short-term use of BackJoy SitSmart Relief and Spine Buddy LT1 H/C chair supports influences neck, upper back, and lower back pain. Forty-eight college students (age, 27.5 ± 6.3 years; height, 1.72 ± 0.08 m; body mass, 78.7 ± 19.8 kg; time seated that day, 4.3 ± 2.8 hours; means ± SD) were recruited for this study. The Nordic Musculoskeletal Questionnaire was used to measure pain for the neck, upper back, and lower back regions. Subjects were randomized to sit in a stationary office chair for a single 12-minute period under 1 of 4 conditions: office chair only (control group), BackJoy SitSmart Relief and chair, freezer-cooled Spine Buddy LT1 H/C and chair, or microwave-heated Spine Buddy LT1 H/C and chair. Participants then completed a posttest Nordic Musculoskeletal Questionnaire. A between-within repeated-measures analysis of variance using the between-subject factor intervention (group) and within-subject factor time (baseline and posttest) was used to analyze study data. The main effect of time across the whole sample was statistically significant for neck (P = .000), upper back (P = .032), and lower back (P = .000) pain; however, there was no statistically significant interaction effect between intervention and time. Thus, as long as participants sat down and rested, symptoms improved similarly across the different groups. In this preliminary study, short-term and single use of a support product for an office chair had no additive effect on reducing neck and back pain. Copyright © 2016. Published by Elsevier Inc.

A Rare Manifestation of Hypothyroid Myopathy: Hoffmann's Syndrome

PubMed Central

Lee, Kang Won; Kim, Kyoung Jin; Kim, Sang Hyun; Kim, Hee Young; Kim, Byung-Jo; Kim, Sin Gon; Choi, Dong Seop

2015-01-01

Hypothyroid myopathy is observed frequently and the resolution of the clinical manifestations of myopathy following thyroid hormone replacement is well known. However, a specific subtype of hypothyroid myopathy, Hoffmann's syndrome, characterized by increased muscular mass (pseudohypertrophy), proximal muscle weakness, muscle stiffness and cramps, is rarely reported. Herein, we describe a 34-year-old male who presented with proximal muscle weakness and non-pitting edema of the lower extremities. He initially visited the neurology department where he was suspected of having polymyositis. Additional laboratory evaluation revealed profound autoimmune hypothyroidism and elevated muscle enzymes including creatine kinase. The patient was started on levothyroxine treatment and, subsequently, clinical symptoms and biochemical parameters resolved with the treatment. The present case highlights that hypothyroidism should be considered in the differential diagnosis of musculoskeletal symptoms even in the absence of overt manifestations of hypothyroidism. To our knowledge, this is the first case reported in Korea. PMID:26394732

Usage Position and Virtual Keyboard Design Affect Upper-Body Kinematics, Discomfort, and Usability during Prolonged Tablet Typing

PubMed Central

Lin, Ming-I Brandon; Hong, Ruei-Hong; Chang, Jer-Hao; Ke, Xin-Min

2015-01-01

Purpose The increase in tablet usage allows people to perform computer work in non-traditional office environments. The aim of this study was to assess the effects of changes in tablet keyboard design on postures of the upper extremities and neck, discomfort, and usability under different usage positions during prolonged touch-typing. Methods Eighteen healthy participants familiar with touch-screen devices were randomized into three usage positions (desk, lap, and bed) and completed six, 60-minute typing sessions using three virtual keyboard designs (standard, wide, split). Electrogoniometers continuously measured the postures of the wrists, elbow, and neck. Body discomfort and system usability were evaluated by questionnaires before and immediately after each typing session. Results Separate linear mixed effects models on various postural measures and subjective ratings are conducted with usage position as the between-subject factors, keyboard design and typing duration as the with-in subject factors were conducted. Using the tablet in bed led to more extended wrists but a more natural elbow flexion than the desk position. The angled split virtual keyboard significantly reduced the extent of wrist ulnar deviation than the keyboard with either standard or wide design. However, little difference was observed across the usage position and keyboard design. When the postural data were compared between the middle and end of typing sessions, the wrists, elbow, and neck all exhibited a substantially increased range of joint movements (13% to 38%). The discomfort rating also increased significantly over time in every upper body region investigated. Additionally, the split keyboard design received a higher usability rating in the bed position, whereas participants had more satisfactory experience while using the wide keyboard in the traditional desk setting. Conclusions Prolonged use of tablets in non-traditional office environments may result in awkward postures in the upper body that may expose users to greater risks of developing musculoskeletal symptoms. Adequate virtual keyboard designs show the potential to alleviate some postural effects and improve the user experience without changing the tablet form factors. PMID:26629989

Musculoskeletal pain, depression, and stress among Latino manual laborers in North Carolina.

PubMed

Tribble, Anna Grace; Summers, Phillip; Chen, Haiying; Quandt, Sara A; Arcury, Thomas A

2016-11-01

The jobs of Latino manual laborers place their mental and physical health at risk. This study evaluates the associations among musculoskeletal pain, mental health, and work organization in Latino manual laborers. Farmworkers and nonfarmworkers (n = 189) in North Carolina were interviewed for self-reported musculoskeletal pain, depressive symptoms, stress, work safety climate, and precarious job status. More nonfarmworkers than farmworkers had neck and shoulder pain, but they did not differ in other areas of musculoskeletal pain. Depressive symptoms had a significant association with neck and shoulder pain (p < .05). Precariousness had a significant association with back pain (p < .05). Farmworker participants had H-2A visas and were afforded some protection compared to nonfarmworker manual workers. Research is needed to improve policy that relieves pain and improves mental health for all Latino manual workers.

Assessment and Management of Musculoskeletal Disorders Among Patients Living with HIV

PubMed Central

Walker-Bone, Karen; Doherty, Erin; Sanyal, Kaushik; Churchill, Duncan

2017-01-01

HIV is a global pandemic. However, anti-retroviral therapy (ART) has transformed the prognosis and providing compliance is good, a normal life expectancy can be anticipated. This has led to a growing population of people with chronic prevalent, treated infection living to older ages. Musculoskeletal symptoms, particularly musculoskeletal pain, is common in HIV patients and, with resumption of near-normal immune function, HIV-infected patients develop inflammatory rheumatic diseases which require assessment and management in rheumatology clinics. Moreover, it is becoming apparent that avascular necrosis and osteoporosis are common comorbidities of HIV. This review will contextualise the prevalence of musculoskeletal symptoms in HIV, informed by data from a UK-based clinic and will discuss the management of active inflammatory rheumatic diseases amongst HIV-infected patients taking ART, highlighting known drug interactions. PMID:28013196

[Work-related musculoskeletal diseases: experience of INAIL of the Apulia region 1998-2001].

PubMed

Allamprese, P; Attimonelli, R; Gigante, M R; Soleo, L

2005-01-01

The insurance recognition of Work related Muscolo Skeletal Disorders (WMSDs) has been introduced in Italy by the sentences of Constitutional Court n. 179/1988 and 208/1988. Afterwards the National Insurance Institute against work injuries (INAIL) tried to make homogeneous, in the different INAIL regional Departments, the diagnostic protocol of the work related illness associated with repetitive manual activities. Since 1998, indeed, a clinical diagnostic protocol has been used in the different departments. This report describes the Work related Muscolo Skeletal Disorders submitted to the Apulian INAIL Regional Direction in the period 1998-2001. Among 84 cases of disease reported to the Regional Direction, 21 were recognised as professional illness, the most part of which in workers employed in services sector and mining activities. The most represented disease was carpal tunnel syndrome and it was more recurrent in men than in women, in which the first symptoms were earlier than in men. The most represented risk factor, both in reported and in recognised cases, was the presence of repetitive working movements of the upper extremities, or the combination of the previous one with other risk factors such as high frequency of working activities, postural risk, strength demand, vibrations, climatic conditions. The development of specific diagnostic criteria, the detailed job analysis and the use of specific questionnaires seem to be the main elements for the WMSDs diagnosis and for the recognition of their professional etiology.

A pilot randomised control trial of the effectiveness of a biofeedback mouse in reducing self-reported pain among office workers.

PubMed

King, Trevor K; Severin, Colette N; Van Eerd, Dwayne; Ibrahim, Selahadin; Cole, Donald; Amick, Ben; Steenstra, Ivan A

2013-01-01

A pilot study examined the effectiveness of a biofeedback mouse in reducing upper extremity pain and discomfort in office workers; in addition, relative mouse use (RMU), satisfaction and the feasibility of running a randomised controlled trial (RCT) in a workplace setting were evaluated. The mouse would gently vibrate if the hand was idle for more than 12 s. The feedback reminded users to rest the arm in neutral, supported postures. Analysis showed a statistically significant reduction in shoulder pain and discomfort for the intervention group at T2 (38.7% lower than controls). Statistically significant differences in RMU time between groups were seen post intervention (-7% at T1 and +15% at T2 for the intervention group). Fifty-five percent of the intervention group was willing to continue using the mouse. It appears feasible to perform an RCT for this type of intervention in a workplace setting. Further study including more participants is suggested. The study findings support the feasibility of conducting randomised control trials in office settings to evaluate ergonomics interventions. The intervention resulted in reduced pain and discomfort in the shoulder. The intervention could be a relevant tool in the reduction of upper extremity musculoskeletal disorder. Further research will better explain the study's preliminary findings.

Extrinsic and intrinsic index finger muscle attachments in an OpenSim upper-extremity model.

PubMed

Lee, Jong Hwa; Asakawa, Deanna S; Dennerlein, Jack T; Jindrich, Devin L

2015-04-01

Musculoskeletal models allow estimation of muscle function during complex tasks. We used objective methods to determine possible attachment locations for index finger muscles in an OpenSim upper-extremity model. Data-driven optimization algorithms, Simulated Annealing and Hook-Jeeves, estimated tendon locations crossing the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints by minimizing the difference between model-estimated and experimentally-measured moment arms. Sensitivity analysis revealed that multiple sets of muscle attachments with similar optimized moment arms are possible, requiring additional assumptions or data to select a single set of values. The most smooth muscle paths were assumed to be biologically reasonable. Estimated tendon attachments resulted in variance accounted for (VAF) between calculated moment arms and measured values of 78% for flex/extension and 81% for ab/adduction at the MCP joint. VAF averaged 67% at the PIP joint and 54% at the DIP joint. VAF values at PIP and DIP joints partially reflected the constant moment arms reported for muscles about these joints. However, all moment arm values found through optimization were non-linear and non-constant. Relationships between moment arms and joint angles were best described with quadratic equations for tendons at the PIP and DIP joints.

Digital vibration threshold testing and ergonomic stressors in automobile manufacturing workers: a cross-sectional assessment.

PubMed

Gold, J E; Punnett, L; Cherniack, M; Wegman, D H

2005-01-01

Upper extremity musculoskeletal disorders (UEMSDs) comprise a large proportion of work-related illnesses in the USA. Physical risk factors including manual force and segmental vibration have been associated with UEMSDs. Reduced sensitivity to vibration in the fingertips (a function of nerve integrity) has been found in those exposed to segmental vibration, to hand force, and in office workers. The objective of this study was to determine whether an association exists between digital vibration thresholds (VTs) and exposure to ergonomic stressors in automobile manufacturing. Interviews and physical examinations were conducted in a cross-sectional survey of workers (n = 1174). In multivariable robust regression modelling, associations with workers' estimates of ergonomic stressors stratified on tool use were determined. VTs were separately associated with hand force, vibration as felt through the floor (whole body vibration), and with an index of multiple exposures in both tool users and non-tool users. Additional associations with contact stress and awkward upper extremity postures were found in tool users. Segmental vibration was not associated with VTs. Further epidemiologic and laboratory studies are needed to confirm the associations found. The association with self-reported whole body vibration exposure suggests a possible sympathetic nervous system effect, which remains to be explored.

Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse

PubMed Central

BARBE, Mary F.; JAIN, Nisha X.; MASSICOTTE, Vicky S.; POPOFF, Steven N.; BARR-GILLESPIE, Ann E.

2015-01-01

We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: 1) HRHF, 2) low repetition low force (LRLF); or 3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions. PMID:25739896

Using Rolling to Develop Neuromuscular Control and Coordination of the Core and Extremities of Athletes

PubMed Central

Voight, Michael L.; Cook, Gray; Gill, Lance

2009-01-01

Rolling is a movement pattern seldom used by physical therapists for assessment and intervention with adult clientele with normal neurologic function. Rolling, as an adult motor skill, combines the use of the upper extremities, core, and lower extremities in a coordinated manner to move from one posture to another. Rolling is accomplished from prone to supine and supine to prone, although the method by which it is performed varies among adults. Assessment of rolling for both the ability to complete the task and bilateral symmetry may be beneficial for use with athletes who perform rotationally-biased sports such as golf, throwing, tennis, and twisting sports such as dance, gymnastics, and figure skating. Additionally, when used as intervention techniques, the rolling patterns have the ability to affect dysfunction of the upper quarter, core, and lower quarter. By applying proprioceptive neuromuscular facilitation (PNF) principles, the therapist may assist patients and clients who are unable to complete a rolling pattern. Examples given in the article include distraction/elongation, compression, and manual contacts to facilitate proper rolling. The combined experience of the four authors is used to describe techniques for testing, assessment, and treatment of dysfunction, using case examples that incorporate rolling. The authors assert that therapeutic use of the developmental pattern of rolling with techniques derived from PNF is a hallmark in rehabilitation of patients with neurologic dysfunction, but can be creatively and effectively utilized in musculoskeletal rehabilitation. PMID:21509112

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals

PubMed Central

2018-01-01

Objective To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. Methods A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. Results There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Conclusion Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture. PMID:29560330

Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals.

PubMed

Choi, Sehoon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog; Han, Seung Hoon

2018-02-01

To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life. A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life. There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups. Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.

Hospitalizations among employees in the Danish hotel and restaurant industry.

PubMed

Hannerz, Harald; Tüchsen, Finn; Kristensen, Tage S

2002-09-01

The aim of the present study was to provide a broad picture of the morbidity among employees in the Danish hotel and restaurant industry. Cohorts of all 20-59-year-old employees in the Danish hotel and restaurant industry in the years 1981, 1986, 1991 and 1994 were formed to calculate age-standardized hospitalization ratios (SHR) and time trends (1981-1997) for many different diagnoses. Both for women and men, significantly higher SHRs were found for infectious and parasitic diseases, neoplasms, diseases in the nervous system and sense organs, diseases of the circulatory system, diseases of the respiratory system, diseases of the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the digestive system and diseases of the musculoskeletal system among employees in hotels and restaurants than in the working population at large. Furthermore, among women a significantly elevated risk was found for injuries in the lower extremities, injuries in the upper extremities and head injuries, and among men a high risk was found for head injuries and a low risk for ruptures in ligaments and muscles. The trend assessments did not detect any significant changes in SHRs over time. Employment in the Danish hotel and restaurant industry is associated with an elevated hospitalization risk due to many diseases, which may be related to occupation and lifestyle. In line with the official policy of reducing inequality in health, focus should be placed on the health problems in this group.

CT contrast extravasation in the upper extremity: strategies for management.

PubMed

Sbitany, Hani; Koltz, Peter F; Mays, Chester; Girotto, John A; Langstein, Howard N

2010-01-01

Extravasation of CT scan contrast media into upper extremity subcutaneous tissue is a relatively frequent complication of injection. Potential sequelae of extravasation include compartment syndrome, skin sloughing, and necrosis. Many institutions institute protocols requiring inpatient plastic surgery consultations immediately following extravasation injury to the upper extremity. We hypothesize that conversion to non-ionic contrast media for contrast CT studies has greatly reduced the incidence of severe extravasation injuries, and may alleviate the need for routine hand surgery consultations. Records from 102 consecutive CT contrast media extravasation injuries were identified. Data acquired from a single institution included type and amount of contrast extravasated, anatomic location, post-procedural clinical symptoms, whether consult was obtained, and final recommendations and outcome. In 102 consecutive cases, immediate surgical therapy was necessary in 0. Non-ionic medium was used in 94% of these cases, and ionic dye was used in 6%. Extravasation of less than 100 cc occurred in 90%, and only 10% were greater. Plastic surgery consultation was immediately obtained in 42% of cases. Factors prompting consultation included extravasation >30 cc, and the presence of erythema or induration. Trends for consultation remained without discernable pattern when patients were stratified by age, amount of extravasate, or anatomic location. Conservative management was recommended in all cases. This included elevation of the extremity, frequent pulse and sensation exams, local message, and temporary splinting. There were no secondary complications requiring surgical intervention. Extravasation of non-ionic CT contrast media appears to be innocuous and can be treated with conservative therapy. Plastic surgery consultation should be obtained when there are obvious signs of skin and soft tissue compromise or symptoms of compartment syndrome. Copyright 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

The impact of social and organizational factors on workers' coping with musculoskeletal symptoms.

PubMed

Torp, S; Riise, T; Moen, B E

2001-07-01

Workers with musculoskeletal symptoms are often advised to cope with their symptoms by changing their working technique and by using lifting equipment. The main objective of this study was to test the hypothesis that negative social and organizational factors where people are employed may prevent workers from implementing these coping strategies. A total of 1,567 automobile garage workers (72%) returned a questionnaire concerning coping with musculoskeletal symptoms and social and organizational factors. When job demands, decision authority, social support, and management support related to health, environment, and safety (HES) were used as predictor variables in a multiple regression model, coping as the outcome variable was correlated with decision authority, social support, and HES-related management support (standardized beta=.079,.12, and.13, respectively). When an index for health-related support and control was added to the model, it correlated with coping (standardized beta=.36), whereas the other relationships disappeared. Decision authority and social support entail health-related support and control that, in turn, influences coping.

Work-related musculoskeletal discomfort among heavy truck drivers.

PubMed

Nazerian, Ramtin; Korhan, Orhan; Shakeri, Ehsan

2018-03-13

Heavy truck drivers are exposed to various psychological, psychosocial and physiological factors, some of which can cause musculoskeletal discomfort in different body regions. This study aims to investigate the correlation between different factors of musculoskeletal discomfort in heavy truck drivers. A cross-sectional study design was applied. A total of 384 participants were interviewed using an updated version of the Nordic musculoskeletal questionnaire. While hypothesis testing was used to assess the association of different factors in musculoskeletal discomfort, logistic regression was applied to explore different correlations among questions of the survey. The results demonstrate that hours of exposure to vibration were associated with discomfort in the neck and shoulders (p < 0.001). This relationship was not statistically significant in the lower back area (p = 0.300). Additionally, 19 equations, their correlations and their odds ratios were formulated with Nagelkerke R 2  > 0.05. Fifty-seven percent of the drivers were suffering from discomfort in their lower back region. Moreover, seat comfort was found to be highly correlated with discomfort in the neck, shoulder and upper back areas. Additionally, with aging the likelihood of experiencing discomfort in the neck, upper back and knees is increased.

TLEM 2.0 - a comprehensive musculoskeletal geometry dataset for subject-specific modeling of lower extremity.

PubMed

Carbone, V; Fluit, R; Pellikaan, P; van der Krogt, M M; Janssen, D; Damsgaard, M; Vigneron, L; Feilkas, T; Koopman, H F J M; Verdonschot, N

2015-03-18

When analyzing complex biomechanical problems such as predicting the effects of orthopedic surgery, subject-specific musculoskeletal models are essential to achieve reliable predictions. The aim of this paper is to present the Twente Lower Extremity Model 2.0, a new comprehensive dataset of the musculoskeletal geometry of the lower extremity, which is based on medical imaging data and dissection performed on the right lower extremity of a fresh male cadaver. Bone, muscle and subcutaneous fat (including skin) volumes were segmented from computed tomography and magnetic resonance images scans. Inertial parameters were estimated from the image-based segmented volumes. A complete cadaver dissection was performed, in which bony landmarks, attachments sites and lines-of-action of 55 muscle actuators and 12 ligaments, bony wrapping surfaces, and joint geometry were measured. The obtained musculoskeletal geometry dataset was finally implemented in the AnyBody Modeling System (AnyBody Technology A/S, Aalborg, Denmark), resulting in a model consisting of 12 segments, 11 joints and 21 degrees of freedom, and including 166 muscle-tendon elements for each leg. The new TLEM 2.0 dataset was purposely built to be easily combined with novel image-based scaling techniques, such as bone surface morphing, muscle volume registration and muscle-tendon path identification, in order to obtain subject-specific musculoskeletal models in a quick and accurate way. The complete dataset, including CT and MRI scans and segmented volume and surfaces, is made available at http://www.utwente.nl/ctw/bw/research/projects/TLEMsafe for the biomechanical community, in order to accelerate the development and adoption of subject-specific models on large scale. TLEM 2.0 is freely shared for non-commercial use only, under acceptance of the TLEMsafe Research License Agreement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Upper Limb Neural Tension and Seated Slump Tests: The False Positive Rate among Healthy Young Adults without Cervical or Lumbar Symptoms

PubMed Central

Davis, D. Scott; Anderson, Ila Beth; Carson, Mary Grace; Elkins, Caroline L.; Stuckey, Lindsey B.

2008-01-01

This study examined the false positive rate of the upper limb neural tension test (ULNTT) and seated slump test (SST) among healthy young adults with no history of cervical, lumbar, or peripheral symptoms. Eighty-four subjects (27 men and 57 women) with a mean age of 22.9 years participated in the investigation. All participants completed a screening questionnaire designed to exclude subjects with a history of cervical or lumbar spine pain or injury, or upper or lower extremity neurological symptoms. The ULNTT and the SST were performed on the left upper and lower extremity of each participant. Of the 84 participants tested, 73 (86.9%) were found to have a positive ULNTT at some point in the available range of elbow extension. Twenty-eight (33.3%) of the 84 subjects had a positive SST at some point in the available range of knee extension. The mean knee extension angle for those subjects with a positive SST was 15.1° with a 95% confidence interval (CI) of 12.3 and 19.7°. The mean elbow extension angle for those with a positive ULNTT was 49.4° with a 95% CI of 44.8 and 54.0°. The number of positive tests for both the ULNTT and the SST was found to be high in this sample of asymptomatic healthy young adults. Based on the results of this investigation, the authors suggest that the current criteria for determining a positive test for both the ULNTT and the SST should be examined using the proposed range of motion cut-off scores. PMID:19119402

Upper Limb Neural Tension and Seated Slump Tests: The False Positive Rate among Healthy Young Adults without Cervical or Lumbar Symptoms.

PubMed

Davis, D Scott; Anderson, Ila Beth; Carson, Mary Grace; Elkins, Caroline L; Stuckey, Lindsey B

2008-01-01

This study examined the false positive rate of the upper limb neural tension test (ULNTT) and seated slump test (SST) among healthy young adults with no history of cervical, lumbar, or peripheral symptoms. Eighty-four subjects (27 men and 57 women) with a mean age of 22.9 years participated in the investigation. All participants completed a screening questionnaire designed to exclude subjects with a history of cervical or lumbar spine pain or injury, or upper or lower extremity neurological symptoms. The ULNTT and the SST were performed on the left upper and lower extremity of each participant. Of the 84 participants tested, 73 (86.9%) were found to have a positive ULNTT at some point in the available range of elbow extension. Twenty-eight (33.3%) of the 84 subjects had a positive SST at some point in the available range of knee extension. The mean knee extension angle for those subjects with a positive SST was 15.1 degrees with a 95% confidence interval (CI) of 12.3 and 19.7 degrees . The mean elbow extension angle for those with a positive ULNTT was 49.4 degrees with a 95% CI of 44.8 and 54.0 degrees . The number of positive tests for both the ULNTT and the SST was found to be high in this sample of asymptomatic healthy young adults. Based on the results of this investigation, the authors suggest that the current criteria for determining a positive test for both the ULNTT and the SST should be examined using the proposed range of motion cut-off scores.

Dutch Musculoskeletal Questionnaire: description and basic qualities.

PubMed

Hildebrandt, V H; Bongers, P M; van Dijk, F J; Kemper, H C; Dul, J

2001-10-10

A questionnaire ('Dutch Musculoskeletal Questionnaire', DMQ) for the analysis of musculoskeletal workload and associated potential hazardous working conditions as well as musculoskeletal symptoms in worker populations is described and its qualities are explored using a database of 1575 workers in various occupations who completed the questionnaire. The 63 questions on musculoskeletal workload and associated potentially hazardous working conditions can be categorized into seven indices (force, dynamic and static load, repetitive load, climatic factors, vibration and ergonomic environmental factors). Together with four separate questions on standing, sitting, walking and uncomfortable postures, the indices constitute a brief overview of the main findings on musculoskeletal workload and associated potentially hazardous working conditions. Homogeneity of the indices is satisfactory. The divergent validity of the indices is fair when compared with an index of psychosocial working conditions and discomfort during exposure to physical loads. Worker groups with contrasting musculoskeletal loads can be differentiated on the basis of the indices and other factors. With respect to the concurrent validity, it appears that most indices and factors show significant associations with low back and/or neck-shoulder symptoms. This questionnaire can be used as a simple and quick inventory for occupational health services to identify worker groups in which a more thorough ergonomic analysis is indicated.

Ergonomic evaluation of a wearable assistive device for overhead work.

PubMed

Rashedi, Ehsan; Kim, Sunwook; Nussbaum, Maury A; Agnew, Michael J

2014-01-01

Overhead work is an important risk factor for upper extremity (UE) musculoskeletal disorders. We examined the potential of a mechanical arm and an exoskeletal vest as a wearable assistive device (WADE) for overhead work. Twelve participants completed 10 minutes of simulated, intermittent overhead work, using each of three payloads (1.1, 3.4 and 8.1 kg) and with/without the WADE. Ratings of perceived discomfort (RPDs) and electromyography (EMG) were obtained for the upper arms, shoulders and low back. Using the WADE, UE RPDs decreased by ∼50% with the heavier payloads, whereas smaller (∼25%) and non-significant increases in low-back RPDs were found and were relatively independent of payload. Changes in RPDs with WADE use were consistent with physical demands indicated by EMG, though EMG-based differences in fatigue were less apparent. Participants generally preferred using the WADE, particularly with heavier payloads. These results supported the potential utility of a WADE as an intervention for overhead work.

Pain associated with the musculoskeletal system in children from Warsaw schools.

PubMed

Słowińska, Iwona; Kwiatkowska, Małgorzata; Jednacz, Ewa; Mańczak, Małgorzata; Rutkowska-Sak, Lidia; Raciborski, Filip

2015-01-01

To assess the prevalence of pain in the musculoskeletal system and possible reasons for these complaints among early age children from Warsaw schools. The study was conducted in 34 randomly selected primary schools in Warsaw in 2011. 2748 survey-questionnaires were given to parents or legal guardians by children. Of these, 1509 surveys were subject to a final analysis. The survey included 66 questions regarding, among other things, pain in the musculoskeletal system in children. Additionally, there were questions about possibly occurring diseases, any postural defects, significant obesity, as well as effects of these complaints on the child's physical activity. Survey data regarded 6-7-year-old children. In the group of 1509 respondents, 242 children (16%) complained about pain in the musculoskeletal system. Pain was located most frequently in the knee joints, and more rarely in the spine and joints in the upper extremities. In the group of children who complained about pain, moderate physical activity was statistically significantly limited. According to parents, physicians did not diagnose any medical conditions in 106 children. Joint disease was diagnosed in 33 children. Postural defects were diagnosed in 589 children. In 123 children complaining about pain at least one postural defect was diagnosed. Such defects were diagnosed statistically significantly more rarely (p = 0.011) in 1234 children who did not complain about pain (460 children). Platypodia or other foot deformation was observed in 25% of these children, spinal curvature in 12%, abnormal knee joint position in 11% and uneven hip position in 2% children. Of note, 17% of all children were significantly overweight. In overweight children the prevalence of pain, especially in the knee joints and feet, was significantly higher. This study aims to underline the problem of musculoskeletal pain in early-age children which limits their physical activity. Also the authors draw attention to the issue of postural defects in a large group of school children. This issue undoubtedly requires more attention and a plan how to create more effective methods of prevention.

Ergonomics and musculoskeletal pain among postgraduate students and faculty members of the School of Dentistry of the University of Barcelona (Spain). A cross-sectional study.

PubMed

Harutunian, Karmen; Gargallo-Albiol, Jordi; Figueiredo, Rui; Gay-Escoda, Cosme

2011-05-01

To evaluate the intensity and location of musculoskeletal pain suffered by students and professors from different postgraduate programs of the School of Dentistry of the University of Barcelona (Spain), to identify the variables related to the occurrence of musculoskeletal symptoms and signs, and to establish possible preventive measures for such disorders. A cross-sectional study was made among students and faculty members from different postgraduate courses of the School of Dentistry at the University of Barcelona between May and June 2007. A total of 74 dentists (54 postgraduate students and 20 faculty members) completed an anonymous questionnaire containing 19 questions. The variables were divided into three main groups: sociodemographic information, ergonomic features and musculoskeletal pain arising from professional practice. Most of the dentists (79.8%) had experienced some kind of musculoskeletal pain in the last 6 months. On comparing the different locations of pain (lumbar, cervical, dorsal, wrist, shoulder and others), the neck was found to be the most commonly affected location (58% of all subjects), and only 34% of the respondents took some preventive measures against musculoskeletal disorders. Women showed a higher frequency of intense pain involving the cervical, lumbar, dorsal and wrist areas (p<0.05). A higher incidence of wrist pain was recorded in professionals exclusively dedicated to oral surgery (p<0.05). No statistically significant correlation was found between the workload (hours) and pain in the different anatomical locations (p>0.05). An important incidence of pain symptoms secondary to musculoskeletal disorders was observed, particularly in the cervical region. Females and younger dentists showed a higher frequency of such symptoms. The implementation of preventive measures is necessary, in view of the high incidence of these disorders.

[Prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in workers of the upholstered furniture industry].

PubMed

Nicoletti, S; Carino, M; Di Leone, G; Trani, G; Carella, F; Rubino, G; Leone, E; Popolizio, R; Colafiglio, S; Ambrosi, L

2008-01-01

The upholstered furniture industry, the so-called "triangle of the sofa industry", is a geographic area of national and strategic economic importance in southern Italy. The single tasks are carried out mostly manually, with the characteristics of a handicraft approach. The aim of the survey was to assess the prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in 30 factories of the sofa industry located in a large geographic area of the Puglia and Basilicata Regions. In the period 1 January-31 December 2003 a network of occupational physicians investigated a population of 5.477 subjects (exposed n=3481, controls n=1996, M=3865, F=1612) in 30 different factories of the area. More than 60 percent of the total workforce studied was employed in large-sized companies (>500 employees). The following work tasks were considered: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Case-definition was assessed through standardized procedures: symptoms by questionnaire plus physical and laboratory/imaging findings. Cumulative prevalence rates of UL-WMSDs as at 31 December 2003 reached values of up to 30% in high risk groups. Prevalence rates showed good correlation with the concise OCRA index used for assessment of exposure to repetitive strain and movements of the upper limb. The most frequently occurring disorders were tendon-related cysts and wrist tendonitis. Shoulder disorders were more frequent in male and female leather-cutting operators. This survey showed a significantly high prevalence of UL-WMSDs in sofa industry workers. It did not seem to be confirmed in this study that there was a greater female susceptibility to UL-WMSDs with the exception of carpal tunnel syndrome: gender difference seems to be less relevant at increasing levels of occupational exposure to repetitive movements and exertion of the upper limbs.

Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain.

PubMed

Generaal, Ellen; Vogelzangs, Nicole; Penninx, Brenda W J H; Dekker, Joost

2017-01-01

The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p < .001) and short sleep duration (HR [95%CI] = 1.52 [1.22-1.90], p < .001) were associated with chronic pain onset. Adding baseline depressive symptoms as a mediator attenuated the associations for insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p < .05). This longitudinal study shows that insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Racket sports.

PubMed

Jayanthi, Neeru; Esser, Stephen

2013-01-01

Tennis may be considered a static and dynamic form of exercise with many well-demonstrated health benefits. Tennis has similar rates of injury to other individual recreational sports and junior competitive sports, without the catastrophic risk of contact/collision sports. Classifying tennis players into junior and elite categories versus adult recreational players may help in outlining volume of play recommendations, exposure risk, and types of injuries. Junior and elite players tend to tolerate higher volumes, have more acute and lower extremity injuries, and have more serious overuse stress injuries. Adult recreational players tend to tolerate lower volumes, have more overuse and upper extremity injuries, and more conditions that are degenerative. Many tennis players also develop asymmetric musculoskeletal adaptations, which may increase risk of specific injury. Tennis-specific evaluations may identify these at-risk segments, help guide preventive strategies including technical errors, and assist in developing return-to-play recommendations. Other racket sports such as squash, badminton, and racquetball have less data available but report both acute and traumatic injuries less commonly seen in tennis.

Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices

PubMed Central

Madhwani, Kishore P.; Nag, P. K.

2017-01-01

Aims: The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics – a unique method for prevention of musculoskeletal discomfort (MSD) – in corporate offices that influences behavior modification. Background: With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. Objective: To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. Materials and Methods: An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions – baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. Statistical Analysis Used: Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. Results: Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41–50% decline in ongoing symptoms. Conclusions: We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources. PMID:29391743

Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices.

PubMed

Madhwani, Kishore P; Nag, P K

2017-01-01

The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics - a unique method for prevention of musculoskeletal discomfort (MSD) - in corporate offices that influences behavior modification. With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions - baseline evaluation ( n = 240) and a follow-up evaluation after 3 months ( n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41-50% decline in ongoing symptoms. We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.

The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review

PubMed Central

2012-01-01

Background Prolonged sitting has been associated with musculoskeletal dysfunction. For desk workers, workstation modifications frequently address the work surface and chair. Chairs which can prevent abnormal strain of the neuromuscular system may aid in preventing musculo-skeletal pain and discomfort. Anecdotally, adjustability of the seat height and the seat pan depth to match the anthropometrics of the user is the most commonly recommended intervention. Within the constraints of the current economic climate, employers demand evidence for the benefits attributed to an investment in altering workstations, however this evidence-base is currently unclear both in terms of the strength of the evidence and the nature of the chair features. The purpose of this study was to evaluate the evidence for the effectiveness of chair interventions in reducing workplace musculoskeletal symptoms. Methods Pubmed, Cinahl, Pedro, ProQuest, SCOPUS and PhysioFocus were searched. ‘Ergonomic intervention’, ‘chair’, ‘musculoskeletal symptoms’, ‘ergonomics’, ‘seated work’ were used in all the databases. Articles were included if they investigated the influence of chair modifications as an intervention; participants were in predominantly seated occupations; employed a pre/post design (with or without control or randomising) and if the outcome measure included neuro-musculoskeletal comfort and/or postural alignment. The risk of bias was assessed using a tool based on The Cochrane Handbook. Results Five studies were included in the review. The number of participants varied from 4 to 293 participants. Three of the five studies were Randomised Controlled Trials, one pre and post-test study was conducted and one single case, multiple baselines (ABAB) study was done. Three studies were conducted in a garment factory, one in an office environment and one with university students. All five studies found a reduction in self-reported musculoskeletal pain immediately after the intervention. Bias was introduced due to poor randomization procedures and lack of concealed allocation. Meta-analysis was not possible due to the heterogeneity of the data (differing population, intervention and outcomes across studies). Conclusion The findings of this review indicate a consistent trend that supports the role of a chair intervention to reduce musculoskeletal symptoms among workers who are required to sit for prolonged periods. However the amount, level and quality of the evidence are only moderate therefore we cannot make strong recommendations until further trials are conducted. The review also highlights gaps: for example in showing whether the effectiveness of a chair intervention has long-term impact, particularly with respect to musculoskeletal symptoms, as well as the recurrence of symptoms and the consequent cost of care. PMID:22889123

Ergonomic Training Reduces Musculoskeletal Disorders among Office Workers: Results from the 6-Month Follow-Up

PubMed Central

Mahmud, Norashikin; Kenny, Dianna Theadora; Md Zein, Raemy; Hassan, Siti Nurani

2011-01-01

Background: Musculoskeletal disorders are commonly reported among computer users. This study explored whether these disorders can be reduced by the provision of ergonomics education. Methods: A cluster randomised controlled trial was conducted in which 3 units were randomised for intervention and received training, and 3 units were given a leaflet. The effect of intervention on workstation habits, musculoskeletal disorders, days and episodes of sick leave, and psychological well-being were assessed. Results: A significant improvement in workstation habits was found, and the differences remained significant at the follow-up time point for keyboard, mouse, chair, and desk use. The largest reduction in the percentage of musculoskeletal disorders was in the neck region (−42.2%, 95% CI −60.0 to −24.4). After adjusting for baseline values, significant differences were found at the follow-up time point in the neck, right shoulder, right and left upper limbs, lower back, and right and left lower limbs. No significant differences were found for the days and episodes of sick leave or the psychological well-being among workers after the intervention. Conclusion: Consistent reductions were observed for all musculoskeletal disorders at the follow-up time point, although the difference was not statistically significant for the upper back. The improvements in the musculoskeletal disorders did not translate into fewer days lost from work or improved psychological well-being. PMID:22135582

Predictors of good general health, well-being, and musculoskeletal disorders in Swedish dental hygienists.

PubMed

Ylipää, V; Arnetz, B B; Preber, H

1999-10-01

The aim of the present study was to examine how different personal, physical, and psychosocial work-associated factors are related to good general health, well-being, and musculoskeletal disorders in dental hygienists. A questionnaire was mailed to 575 dental hygienists who were randomly sampled from the Swedish Dental Hygienists' Association (86% responded). Data were analyzed with multiple-logistic regression models. The results showed that high clinical-practice fraction, active leisure, and high management support increased the odds for good general health, while work and family overload decreased the odds. Management support and mastery of work increased the odds for well-being, while work and family overload and high work efficiency decreased them. Scaling work increased the odds for general and work-related musculoskeletal disorders in all parts of the upper body and arms but not in the lower back. In the upper body, active leisure decreased the odds for general musculoskeletal disorders, while the odds for work-related musculoskeletal disorders increased from work and family overload and decreased from many weekly working hours. Many years in the profession increased the odds for general finger disorders. In conclusion, the results suggest that active leisure and several psychosocial work factors strongly influence good general health and well-being. Physical tasks influence musculoskeletal disorders more than active leisure and psychosocial work factors.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil

PubMed Central

Lacerda, Eliana M; Nácul, Luis C; da S Augusto, Lia G; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-01-01

Background The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. Methods We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. Results We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. Conclusion The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population. PMID:16219095

Statins: pros and cons.

PubMed

Pinal-Fernandez, Iago; Casal-Dominguez, Maria; Mammen, Andrew L

2018-05-23

Statins inhibit the critical step of cholesterol synthesis in which 3-hydroxy-3-methylglutaryl coenzyme A (HMGC) is transformed to mevalonate by the enzyme HMGC reductase. By doing so, they have a potent lipid-lowering effect that reduces cardiovascular risk and decreases mortality. Since the mevalonate pathway also influences endothelial function, the inflammatory response, and coagulation, the effects of statins reach well beyond their cholesterol lowering properties. As with all drugs, statins may have adverse effects; these include musculoskeletal symptoms, increased risk of diabetes, and higher rates of hemorrhagic stroke. However, the frequency of adverse effects is extremely low and, in selected patient populations, the benefits of statins considerably outweigh the potential risks. Published by Elsevier España, S.L.U.

Musculoskeletal Pain, Depression and Stress among Latino Manual Laborers in North Carolina

PubMed Central

Tribble, Anna Grace; Summers, Phillip; Chen, Haiying; Quandt, Sara A.; Arcury, Thomas A.

2016-01-01

The jobs of Latino manual laborers place their mental and physical health at risk. This study evaluates the associations among musculoskeletal pain, mental health, and work organization in Latino manual laborers. Farmworkers and non-farmworkers (n=189) in North Carolina were interviewed for self-reported musculoskeletal pain, depressive symptoms, stress, work safety climate, and precarious job status. More non-farmworkers than farmworkers had neck and shoulder pain, but they did not differ in other areas of musculoskeletal pain. Depressive symptoms had a significant association with neck and shoulder pain (p<0.05). Precariousness had a significant association with back pain (p<0.05). Farmworker participants had H-2A visas and were afforded some protection compared to non-farmworker manual workers. Research is needed to improve policy that relieves pain and improves mental health for all Latino manual workers. PMID:26422551

Education of garment workers: prevention of work related musculoskeletal disorders.

PubMed

Pun, Jane Chao; Burgel, Barbara J; Chan, Jackie; Lashuay, Nan

2004-08-01

This educational intervention was designed as part of a garment worker occupational health and safety initiative, with the goal to reduce musculoskeletal symptoms in this monolingual Cantonese speaking population. Using risk communication and the Chinese concepts of yin and yang, the class curriculum was designed to be participatory. It focused on linking symptoms to high risk work activities; explaining the nature of musculoskeletal injury; and encouraging compliance with self care measures of ice, stretching, and early symptom reporting. A total of 21 women completed the Healthy Work Classes, with an increase in perceived levels of energy measured after each class. Additionally, contingency contracting for both individual and workplace change was piloted. This curriculum was revised to become a "train the trainer" program, with training of garment worker leaders and the goal to disseminate this prevention based curriculum to garment workers in the Oakland, California community.

Effect of office ergonomics intervention on reducing musculoskeletal symptoms.

PubMed

Amick, Benjamin C; Robertson, Michelle M; DeRango, Kelly; Bazzani, Lianna; Moore, Anne; Rooney, Ted; Harrist, Ron

2003-12-15

Office workers invited and agreeing to participate were assigned to one of three study groups: a group receiving a highly adjustable chair with office ergonomics training, a training-only group, and a control group receiving the training at the end of the study. To examine the effect of office ergonomics intervention in reducing musculoskeletal symptom growth over the workday and, secondarily, pain levels throughout the day. Data collection occurred 2 months and 1 month before the intervention and 2, 6, and 12 months postintervention. During each round, a short daily symptom survey was completed at the beginning, middle, and end of the workday for 5 days during a workweek to measure total bodily pain growth over the workday. Multilevel statistical models were used to test hypotheses. The chair-with-training intervention lowered symptom growth over the workday (P = 0.012) after 12 months of follow-up. No evidence suggested that training alone lowered symptom growth over the workday (P = 0.461); however, average pain levels in both intervention groups were reduced over the workday. Workers who received a highly adjustable chair and office ergonomics training had reduced symptom growth over the workday. The lack of a training-only group effect supports implementing training in conjunction with highly adjustable office furniture and equipment to reduce symptom growth. The ability to reduce symptom growth has implications for understanding how to prevent musculoskeletal injuries in knowledge workers.

The prevalence of musculoskeletal symptoms in the construction industry: a systematic review and meta-analysis.

PubMed

Umer, Waleed; Antwi-Afari, Maxwell F; Li, Heng; Szeto, Grace P Y; Wong, Arnold Y L

2018-02-01

Although individual studies have reported high prevalence of musculoskeletal symptoms (MSS) among construction workers, no systematic review has summarized their prevalence rates. Accordingly, this systematic review/meta-analysis aimed to synthesize MSS prevalence in different construction trades, gender and age groups, which may help develop specific ergonomic interventions. Nine databases were searched for articles related to the research objective. Two reviewers independently screened citations, extracted information and conducted quality assessment of the included studies. Meta-analyses were conducted on clinical and statistical homogenous data. Thirty-five out of 1130 potential citations were included reporting diverse types of period prevalence and case definitions. Only the 1-year prevalence rates of MSS (defined as at least one episode of pain/MSS in the last year) at nine anatomical regions had sufficient homogeneous data for meta-analysis. Specifically, the 1-year prevalence of MSS was 51.1% for lower back, 37.2% for knee, 32.4% for shoulder, 30.4% for wrist, 24.4% for neck, 24.0% for ankle/foot, 20.3% for elbow, 19.8% for upper back, and 15.1% for hip/thigh. Female workers demonstrated a higher prevalence of MSS while there was insufficient information on the prevalence of trade-specific or age-related MSS. The quality assessments revealed that many included studies estimated prevalence solely based on self-reported data, and did not report non-respondents' characteristics. Lumbar, knee, shoulder, and wrist MSS are the most common symptoms among construction workers. Future studies should standardize the reporting of period prevalence of MSS in different construction trades to allow meta-analyses and to develop relevant MSS prevention program.

Musculoskeletal complaints among Italian X-ray technology students: a cross-sectional questionnaire survey

PubMed Central

2010-01-01

Background There is a high prevalence of musculoskeletal disorders among healthcare professional students. Although recent studies show musculoskeletal disorders are a common problem among X-ray technologists, there are no data on these disorders among students of this healthcare profession. We have therefore estimated the prevalence of musculoskeletal complaints among a group of X-ray technology students. Methods The students (n = 109) currently attending the 3-year X-ray technologist school at a large University in the Apulia region of Southern Italy were recruited for the study, with a 100% participation rate. A questionnaire collected data concerning personal characteristics, physical exposure during training activities, and the presence of musculoskeletal symptoms in the neck, shoulders, low back, hand/wrist and legs. Results The prevalence of complaints in any body site over the previous 12 months was 37%. Low back pain was the most frequently reported symptom (27%), followed by neck (16%), shoulder (11%), leg (8%) and hand/wrist (5%) pain. Poor physical activity was associated with the complaints. Conclusions Our study showed prevalence rates of musculoskeletal complaints among X-ray technology students to be somewhat high, representing about half of those found in Italian technologists. The most common musculoskeletal problem was low back pain, which had also been found in research conducted among nursing students. Our research also showed a significant association between poor physical activity and the presence of musculoskeletal disorders in young university students. PMID:20416101

Occupational ergonomics and injury prevention.

PubMed

Stobbe, T J

1996-01-01

Ergonomics is the study of people at work. The current focus is on the prevention of work-induced musculoskeletal injuries through the application of sound ergonomic principles. This chapter has briefly outlined ergonomics and its history, has described low back pain and upper extremity cumulative trauma disorders from an ergonomic perspective, and has discussed control and prevention approaches for a few scenarios. Ergonomic principles are based on a combination of science and engineering and a thorough understanding of human capabilities and limitations. When these principles are applied to the design of a job, task, process, or procedure, the incidence and severity of musculoskeletal injuries decrease. In many cases productivity and morale also improve. Workers are spared suffering, and employers are spared costs. It is hoped that this discussion will encourage more health, safety, and business professionals to learn about and apply ergonomics in their workplaces for the improvement of the worker, product, and business. Finally, many additional epidemiologic studies on the individual and joint effects of the CTD risk factors are needed. The knowledge gained from these studies will promote the more effective application of ergonomic principles to reduce worker suffering, improve products, and reduce costs.

Prognostic factors for specific lower extremity and spinal musculoskeletal injuries identified through medical screening and training load monitoring in professional football (soccer): a systematic review

PubMed Central

Sergeant, Jamie C; Parkes, Matthew J; Callaghan, Michael J

2017-01-01

Background Medical screening and load monitoring procedures are commonly used in professional football to assess factors perceived to be associated with injury. Objectives To identify prognostic factors (PFs) and models for lower extremity and spinal musculoskeletal injuries in professional/elite football players from medical screening and training load monitoring processes. Methods The MEDLINE, AMED, EMBASE, CINAHL Plus, SPORTDiscus and PubMed electronic bibliographic databases were searched (from inception to January 2017). Prospective and retrospective cohort studies of lower extremity and spinal musculoskeletal injury incidence in professional/elite football players aged between 16 and 40 years were included. The Quality in Prognostic Studies appraisal tool and the modified Grading of Recommendations Assessment, Development and Evaluation synthesis approach was used to assess the quality of the evidence. Results Fourteen studies were included. 16 specific lower extremity injury outcomes were identified. No spinal injury outcomes were identified. Meta-analysis was not possible due to heterogeneity and study quality. All evidence related to PFs and specific lower extremity injury outcomes was of very low to low quality. On the few occasions where multiple studies could be used to compare PFs and outcomes, only two factors demonstrated consensus. A history of previous hamstring injuries (HSI) and increasing age may be prognostic for future HSI in male players. Conclusions The assumed ability of medical screening tests to predict specific musculoskeletal injuries is not supported by the current evidence. Screening procedures should currently be considered as benchmarks of function or performance only. The prognostic value of load monitoring modalities is unknown. PMID:29177074

Do work technique and musculoskeletal symptoms differ between men and women performing the same type of work tasks?

PubMed

Dahlberg, Raymond; Karlqvist, Lena; Bildt, Carina; Nykvist, Karin

2004-11-01

Musculoskeletal disorders are more common among women than among men. When comparing the difference between men and women in the prevalence of musculoskeletal disorders, methodological problems arise as men and women seldom perform the same type of activities, neither at work nor at home. The main objective of this cross-sectional case study was to compare work technique and self-reported musculoskeletal symptoms between men and women performing the same type of work tasks within a metal industry. Other factors, such as leisure activities, were also taken into consideration. Three data collection methods were used; questionnaire, interviews and systematic observations. The results from the observations revealed that women worked more frequently and during longer times with their hands above shoulder height than men. Working with hands above shoulder height is considered a risk factor for neck and shoulder disorders according to previous studies. Workplace design factors were probably a reason for differences in working technique between men and women. A higher proportion of women than men reported shoulder symptoms. Women spent more time on household activities than men, which indicates a higher total workload in paid and unpaid work.

[Musculo-skeletal disorders of the upper limb in the "new tables of professional diseases in industry and agriculture"].

PubMed

Clemente, M

2008-01-01

The author, after an analysis of the statistical data on work-related diseases reported to the INAIL and listed on the Annual Report 2007, examines the main highlights of the "new tables of professional diseases in industry and agriculture" published in the Ministerial Decree of July 21st, 2008 (GU n.169, 21-7-2008), also relating to the introduction of musculo-skeletal disorders of the upper limb due to bio-mechanical strain into the list of professional diseases to which the legal presumption of origin is applicable.

Three job stress models and their relationship with musculoskeletal pain in blue- and white-collar workers.

PubMed

Herr, Raphael M; Bosch, Jos A; Loerbroks, Adrian; van Vianen, Annelies E M; Jarczok, Marc N; Fischer, Joachim E; Schmidt, Burkhard

2015-11-01

Musculoskeletal pain has been found to co-occur with psychosocial job stress. However, different conceptualizations of job stress exist, each emphasizing different aspects of the work environment, and it is unknown which of these aspects show the strongest associations with musculoskeletal pain. Further, these associations may differ for white-collar vs. blue-collar job types, but this has not been tested. The present study examined the independent and combined contributions of Effort-RewardImbalance (ERI), Job-Demand-Control (JDC) and Organizational Justice (OJ) to musculoskeletal pain symptoms among white- and blue-collar workers. Participants of a cross-sectional study (n=1634) completed validated questionnaires measuring ERI, JDC, and OJ, and reported the frequency of pain during the previous year at four anatomical locations (lower back, neck or shoulder, arms and hands, and knees/feet). Pain reports were summarized into a single musculoskeletal symptom score (MSS). Analyses were stratified for white- and blue-collar workers. Among white-collar workers, ERI and OJ were independently associated with MSS. In addition to these additive effects, significant 2-way and 3-way interactions indicated a synergistic effect of job stressors in relation to reported pain. In blue-collar workers, ERI and JDC independently associated with MSS, and a significant 3-way interaction was observed showing that the combination of job stressors exceeded an additive effect. ERI influences pain symptoms in both occupational groups. OJ was independent significant predictor only among white-collar workers, whereas JDC had additive predictive utility exclusively among blue-collar workers. Simultaneous exposure to multiple job stress factors appeared to synergize pain symptom reporting. Copyright © 2015. Published by Elsevier Inc.

Urinary Incontinence Symptoms and Impact on Quality of Life in Patients Seeking Outpatient Physical Therapy Services

PubMed Central

Alappattu, Meryl; Neville, Cynthia; Beneciuk, Jason; Bishop, Mark

2016-01-01

Objective The objective of this study was to examine the frequency and types of urinary incontinence (UI) in patients seeking outpatient physical therapy for neuro-musculoskeletal conditions. Design Retrospective cross-sectional analysis. Patients A convenience sample of patients that positively responded to a UI screening question were included in this study. Methods Data were collected for age, sex, and primary treatment condition classified into one of the following (i.e. urinary dysfunction; fecal dysfunction; pelvic pain; spine; neurological disorders; or extremity disorders); UI type (i.e. mixed, urge, stress, or insensible); UI symptom severity; and quality of life impact. Main Outcome Measures Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. Results The mean age of the sample (n=599) was 49.8 years (SD=18.5) and 94.7% were female. The urinary dysfunction group comprised 44.2% of the total sample, followed by the spine group with 25.7%, and pelvic pain with 17.2%. The urinary dysfunction group scored significantly higher on UI symptom severity and impact on quality of life compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorders group. Conclusion These preliminary data indicate that UI is a condition afflicting many individuals who present to outpatient physical therapy beyond those seeking care for UI. We recommend using a simple screening measure for UI and its impact on HRQoL as part of a routine initial evaluation in outpatient physical therapy settings. PMID:26863987

Urinary incontinence symptoms and impact on quality of life in patients seeking outpatient physical therapy services.

PubMed

Alappattu, Meryl; Neville, Cynthia; Beneciuk, Jason; Bishop, Mark

2016-01-01

The objective of this study was to examine the frequency and types of urinary incontinence (UI) in patients seeking outpatient physical therapy for neuro-musculoskeletal conditions. Retrospective cross-sectional analysis. A convenience sample of patients that positively responded to a UI screening question was included in this study. Data were collected for age, sex, and primary treatment condition classified into one of the following (i.e., urinary dysfunction, fecal dysfunction, pelvic pain, spine, neurological disorders, or extremity disorders); UI type (i.e., mixed, urge, stress, or insensible); UI symptom severity; and quality of life (QoL) impact. Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. The mean age of the sample (n = 599) was 49.8 years (SD = 18.5) and 94.7% were female. The urinary dysfunction group comprised 44.2% of the total sample, followed by the spine group with 25.7% and pelvic pain with 17.2%. The urinary dysfunction group scored significantly higher on UI symptom severity and impact on QoL compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorder group. These preliminary data indicate that UI is a condition afflicting many individuals who present to outpatient physical therapy beyond those seeking care for UI. We recommend using a simple screening measure for UI and its impact on HRQoL as part of a routine initial evaluation in outpatient physical therapy settings.

Ergonomics and human factors in endoscopic surgery: a comparison of manual vs telerobotic simulation systems.

PubMed

Lee, E C; Rafiq, A; Merrell, R; Ackerman, R; Dennerlein, J T

2005-08-01

Minimally invasive surgical techniques expose surgeons to a variety of occupational hazards that may promote musculoskeletal disorders. Telerobotic systems for minimally invasive surgery may help to reduce these stressors. The objective of this study was to compare manual and telerobotic endoscopic surgery in terms of postural and mental stress. Thirteen participants with no experience as primary surgeons in endoscopic surgery performed a set of simulated surgical tasks using two different techniques--a telerobotic master--slave system and a manual endoscopic surgery system. The tasks consisted of passing a soft spherical object through a series of parallel rings, suturing along a line 5-cm long, running a 32-in ribbon, and cannulation. The Job Strain Index (JSI) and Rapid Upper Limb Assessment (RULA) were used to quantify upper extremity exposure to postural and force risk factors. Task duration was quantified in seconds. A questionnaire provided measures of the participants' intuitiveness and mental stress. The JSI and RULA scores for all four tasks were significantly lower for the telerobotic technique than for the manual one. Task duration was significantly longer for telerobotic than for manual tasks. Participants reported that the telerobotic technique was as intuitive as, and no more stressful than, the manual technique. Given identical tasks, the time to completion is longer using the telerobotic technique than its manual counterpart. For the given simulated tasks in the laboratory setting, the better scores for the upper extremity postural analysis indicate that telerobotic surgery provides a more comfortable environment for the surgeon without any additional mental stress.

Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk?

PubMed

Silverstein, Barbara; Fan, Z Joyce; Smith, Caroline K; Bao, Stephen; Howard, Ninica; Spielholz, Peregrin; Bonauto, David; Viikari-Juntura, Eira

2009-03-01

The aim was to explore whether "adjustment" for gender masks important exposure differences between men and women in a study of rotator cuff syndrome (RCS) and carpal tunnel syndrome (CTS) and work exposures. This cross-sectional study of 733 subjects in 12 health care and manufacturing workplaces used detailed individual health and work exposure assessment methods. Multiple logistic regression analysis was used to compare gender stratified and adjusted models. Prevalence of RCS and CTS among women was 7.1% and 11.3% respectively, and among men 7.8% and 6.4%. In adjusted (gender, age, body mass index) multivariate analyses of RCS and CTS, gender was not statistically significantly different. For RCS, upper arm flexion >/=45 degrees and forceful pinch increased the odds in the gender-adjusted model (OR 2.66, 95% CI 1.26-5.59) but primarily among women in the stratified analysis (OR 6.68, 95% CI 1.81-24.66 versus OR 1.45, 95% CI 0.53-4.00). For CTS, wrist radial/ulnar deviation >/=4% time and lifting >/=4.5kg >3% time, the adjusted OR was higher for women (OR 4.85, 95% CI 2.12-11.11) and in the gender stratified analyses, the odds were increased for both genders (women OR 5.18, 95% CI 1.70-15.81 and men OR 3.63, 95% CI 1.08-12.18). Gender differences in response to physical work exposures may reflect gender segregation in work and potential differences in pinch and lifting capacity. Reduction in these exposures may reduce prevalence of upper extremity disorders for all workers.

Association Between Smartphone Use and Musculoskeletal Discomfort in Adolescent Students.

PubMed

Yang, Shang-Yu; Chen, Ming-De; Huang, Yueh-Chu; Lin, Chung-Ying; Chang, Jer-Hao

2017-06-01

Despite the substantial increase in the number of adolescent smartphone users, few studies have investigated the behavioural effects of smartphone use on adolescent students as it relates to musculoskeletal discomfort. The purpose of this study was to explore the association between smartphone use and musculoskeletal discomfort in students at a Taiwanese junior college. We hypothesised that the duration of smartphone use would be associated with increased instances of musculoskeletal discomfort in these students. This cross-sectional study employed a convenience sampling method to recruit students from a junior college in southern Taiwan. All the students (n = 315) were asked to answer questionnaires on smartphone use. A descriptive analysis, stepwise regression, and logistic regression were used to examine specific components of smartphone use and their relationship to musculoskeletal discomfort. Nearly half of the participants experienced neck and shoulder discomfort. The stepwise regression results indicated that the number of body parts with discomfort (F = 6.009, p < 0.05) increased with hours spent using ancillary smartphone functions. The logistic regression analysis showed that the students who talked on the phone >3 h/day had a higher risk of upper back discomfort than did those who talked on the phone <1 h/day [odds ratio (OR) = 4.23, p < 0.05]. This study revealed that the relationship between smartphone use and musculoskeletal discomfort is related to the duration of smartphone ancillary function use. Moreover, hours spent talking on the phone was a predictor of upper back discomfort.

Cause, prevalence, and response to occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants.

PubMed

Holder, N L; Clark, H A; DiBlasio, J M; Hughes, C L; Scherpf, J W; Harding, L; Shepard, K F

1999-07-01

Physical therapists (PTs) and physical therapist assistants (PTAs) are susceptible to occupational musculoskeletal injuries. The purpose of this study was to examine the reported causes and prevalence of occupational musculoskeletal injuries to PTs and PTAs during a 2-year period. A questionnaire was mailed to 500 PTs and 500 PTAs randomly selected from the American Physical Therapy Association 1996 active membership list. Six hundred sixty-seven questionnaires were returned, giving a response rate of 67%. Based on a literature review and a pilot study, an occupational injury questionnaire was constructed and mailed. Self-reports of injuries were obtained. Thirty-two percent of the PTs and 35% of the PTAs reported sustaining a musculoskeletal injury. The highest prevalence of injury was to the low back (62% of injured PTs and 56% of injured PTAs). The PTs reported the upper back and the wrist and hand as having the second highest prevalence (23%). The PTAs reported the upper back as having the second highest prevalence (28%). The PTs and PTAs reported making changes in their work habits of improved body mechanics, increased use of other personnel, and frequent change of work position. The majority of PTs and PTAs reported they did not limit patient contact time or area of practice after sustaining an injury. Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.

Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol.

PubMed

Jay, Kenneth; Brandt, Mikkel; Sundstrup, Emil; Schraefel, Mc; Jakobsen, Markus D; Sjøgaard, Gisela; Andersen, Lars L

2014-12-18

Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor control and may result in extended periods of time spent in static positions.In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions, multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges.The aim of this study is therefore to investigate the effect of an individually tailored biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants receive either an individualized multifactorial intervention or "usual care" for 10 weeks at the worksite. 1) female laboratory technician (18-67 years of age) and 2) Pain intensity ≥ 3 (0-10 Visual Analogue Scale) lasting ≥3 months with a frequency of ≥ 3 days per week in one or more of the following regions: i) upper back i) low back iii) neck, iv) shoulder, v) elbow and/or vi) hand. 1) life-threatening disease and 2) pregnancy. Stress, as measured by Cohen´s perceived stress questionnaire is not an inclusion criteria, thus participants can participate regardless of their stress level.We will implement an individualized intervention addressing biopsychosocial elements of musculoskeletal pain with the following components; i) increasing physical capacity through strength- and motor control training; ii) lowering or preventing development of stress through mindfulness practice and learning de-catastrophizing pain management strategies through cognitive training.The primary outcome at 10-week follow-up is the between-group difference in intensity of perceived musculoskeletal pain during the last week (average value of back, neck, shoulder, elbow and hand) assessed by questionnaire (modified visual analogue scale 0-10). This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress. ClinicalTrials.gov NCT02047669.

Musculoskeletal pain among women of menopausal age in Puebla, Mexico.

PubMed

Sievert, Lynnette Leidy; Goode-Null, Susan K

2005-06-01

Worldwide, complaints of musculoskeletal pain are more frequent than complaints of hot flashes amongst women of menopausal age. The purpose of this study was to examine musculoskeletal pain among women of menopausal age in the city of Puebla, Mexico. An opportunity sample was recruited from public parks and markets, with representation from all social classes (n=755). Mean age was 50.1 years, and the majority were employed as saleswomen in small businesses. Symptom frequencies were collected by open-ended interviews and with a structured symptom list that queried symptom experience during the two weeks prior to interview. In response to open-ended questions, "dolores de huesos" (bone pain) was volunteered by 47% of respondents as a symptom associated with menopause, second only to hot flashes (53%). From the structured symptom list, 55.8% and 55.6% reported back pain and joint stiffness during the two weeks prior to interview. Women with back pain and joint stiffness were less likely to report being active during their leisure time (p<.01). The results of backwards stepwise logistic regressions indicate that women with back pain were more likely to be older, with less education, a higher BMI, and ate less meat. Women with joint pain were more likely to be post-menopausal, with less education, more children, a higher BMI, and were likely to drink milk and coffee more than once/week but less than once/day. While menopause is not necessarily a risk factor for musculoskeletal pain, it is important to recognize the pervasiveness of this complaint among women of menopausal age.

A Study to Evaluate Genetic Predictors of Aromatase Inhibitor Musculoskeletal Symptoms (AIMSS)

ClinicalTrials.gov

2015-05-07

Estrogen Receptor-positive Breast Cancer; Musculoskeletal Complications; Progesterone Receptor-positive Breast Cancer; Recurrent Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

The Impact of Ergonomically Designed Workstations on Shoulder EMG Activity during Carpet Weaving

PubMed Central

Motamedzade, Majid; Afshari, Davood; Soltanian, Alireza

2014-01-01

Background: The present study aimed to evaluate the biomechanical exposure to the trapezius muscle activity in female weavers for a prolonged period in the workstation A (suggested by previous studies) and workstation B (proposed by the present study). Methods: Electromyography data were collected from nine females during four hours for each ergonomically designed workstation at the Ergonomics Laboratory, Hamadan, Iran. The design criteria for ergonomically designed workstations were: 1) weaving height (20 and 3 cm above elbow height for workstations A and B, respectively), and 2) seat type (10° and 0° forwardsloping seat for workstations A and B, respectively). Results: The amplitude probability distribution function (APDF) analysis showed that the left and right upper trapezius muscle activity was almost similar at each workstation. Trapezius muscle activity in the workstation A was signifi­cantly greater than workstations B (P<0.001). Conclusion: In general, use of workstation B leads to significantly reduced muscle activity levels in the upper trapezius as compared to workstation A in weavers. Despite the positive impact of workstation B in reducing trapezius muscle activity, it seems that constrained postures of the upper arm during weaving may be associated with musculoskeletal symptoms. PMID:25650180

The Impact of Ergonomically Designed Workstations on Shoulder EMG Activity during Carpet Weaving.

PubMed

Motamedzade, Majid; Afshari, Davood; Soltanian, Alireza

2014-01-01

The present study aimed to evaluate the biomechanical exposure to the trapezius muscle activity in female weavers for a prolonged period in the workstation A (suggested by previous studies) and workstation B (proposed by the present study). Electromyography data were collected from nine females during four hours for each ergonomically designed workstation at the Ergonomics Laboratory, Hamadan, Iran. The design criteria for ergonomically designed workstations were: 1) weaving height (20 and 3 cm above elbow height for workstations A and B, respectively), and 2) seat type (10° and 0° forwardsloping seat for workstations A and B, respectively). The amplitude probability distribution function (APDF) analysis showed that the left and right upper trapezius muscle activity was almost similar at each workstation. Trapezius muscle activity in the workstation A was signifi-cantly greater than workstations B (P<0.001). In general, use of workstation B leads to significantly reduced muscle activity levels in the upper trapezius as compared to workstation A in weavers. Despite the positive impact of workstation B in reducing trapezius muscle activity, it seems that constrained postures of the upper arm during weaving may be associated with musculoskeletal symptoms.

Occurrence of lead-related symptoms below the current occupational safety and health act allowable blood lead levels.

PubMed

Rosenman, Kenneth D; Sims, Amy; Luo, Zhehui; Gardiner, Joseph

2003-05-01

To determine the occurrence of symptoms of lead toxicity at levels below the current allowable Occupational Safety and Health Act blood lead level of 50 micrograms/dL, standardized telephone interviews were conducted of individuals reported to a statewide laboratory-based surveillance system. Four hundred and ninety-seven, or 75%, of the eligible participants were interviewed. Gastrointestinal, musculoskeletal, and nervous system symptoms increased with increasing blood lead levels. Nervous, gastrointestinal, and musculoskeletal symptoms all began to be increased in individuals with blood leads between 30-39 micrograms/dL and possibly at levels as low as 25-30 micrograms/dL for nervous system symptoms. The results of this study of increased symptoms are consistent with and provide added weight to previous results showing subclinical changes in the neurologic and renal systems and sperm counts at blood lead levels currently allowed by the Occupational Safety and Health Act.

PROMIS Physical Function Computer Adaptive Test Compared With Other Upper Extremity Outcome Measures in the Evaluation of Proximal Humerus Fractures in Patients Older Than 60 Years.

PubMed

Morgan, Jordan H; Kallen, Michael A; Okike, Kanu; Lee, Olivia C; Vrahas, Mark S

2015-06-01

To compare the PROMIS Physical Function Computer Adaptive Test (PROMIS PF CAT) to commonly used traditional PF measures for the evaluation of patients with proximal humerus fractures. Prospective. Two Level I trauma centers. Forty-seven patients older than 60 years with displaced proximal humerus fractures treated between 2006 and 2009. Evaluation included completion of the PROMIS PF CAT, the Constant Shoulder Score, the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Short Musculoskeletal Functional Assessment (SMFA). Observed correlations among the administered PF outcome measures. On average, patients responded to 86 outcome-related items for this study: 4 for the PROMIS PF CAT (range: 4-8 items), 6 for the Constant Shoulder Score, 30 for the DASH, and 46 for the SMFA. Time to complete the PROMIS PF CAT (median completion time = 98 seconds) was significantly less than that for the DASH (median completion time = 336 seconds, P < 0.001) and for the SMFA (median completion time = 482 seconds, P < 0.001). PROMIS PF CAT scores correlated statistically significantly and were of moderate-to-high magnitude with all other PF outcome measure scores administered. This study suggests using the PROMIS PF CAT as a sole PF outcome measure can yield an assessment of upper extremity function similar to those provided by traditional PF measures, while substantially reducing patient assessment time.

Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting

PubMed Central

Ahmad, Imran

2018-01-01

This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF) of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years). Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper) and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA) was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks. PMID:29670002

Relationship between Body Mass Index, Cardiorespiratory and Musculoskeletal Fitness among South African Adolescent Girls.

PubMed

Bonney, Emmanuel; Ferguson, Gillian; Smits-Engelsman, Bouwien

2018-05-28

Background : Cardiorespiratory and musculoskeletal fitness are important health indicators that support optimal physical functioning. Understanding the relationship between body mass index and these health markers may contribute to the development of evidence-based interventions to address obesity-related complications. The relationship between body mass index, cardiorespiratory and musculoskeletal fitness has not been well explored, particularly in female adolescents. The aim of this study was to investigate the association between body mass index, cardiorespiratory and musculoskeletal fitness among South African adolescent girls in low-income communities. Methods : This cross-sectional study included 151 adolescent girls, aged 13⁻16 years. Cardiorespiratory fitness was measured using the 20 m shuttle run test and musculoskeletal fitness was assessed using a variety of field-based tests. Height and weight were measured with standardised procedures and body mass index (BMI) was derived by the formula [BMI = weight (kg)/height (m)²]. Participants were categorised into three BMI groups using the International Obesity Task Force age- and gender-specific cut-off points. Pearson correlations were used to determine the association between body mass index, cardiorespiratory fitness and measures of musculoskeletal fitness at p ≤ 0.05. Results : Overweight and obese girls were found to have lower cardiorespiratory fitness, decreased lower extremity muscular strength, greater grip strength, and more hypermobile joints compared to normal-weight peers. BMI was negatively associated with cardiorespiratory fitness and lower extremity muscular strength. Conclusions : The findings indicate that increased body mass correlates with decreased cardiorespiratory and musculoskeletal fitness. Interventions should be developed to target these important components of physical fitness in this demographic group.

Back and neck pain disability and upper limb symptoms of home healthcare workers: A case-control study from Northern Italy.

PubMed

Riccò, Matteo; Pezzetti, Federica; Signorelli, Carlo

2017-03-30

Work-related musculoskeletal disorders (MSD) are quite frequent in healthcare workers (HCWs), but data about MSD in home-based healthcare workers (HHWs) are lacking. In this study we describe the prevalence of MSD among Italian HHWs. A case-control study was carried out among 300 random-selected female HCWs, the sample comprising 100 HHWs, 100 HCWs with a low exposure to patient handling (MAPO - Movimentazione e Assistenza Pazienti Ospedalizzati - Movement and Assistance of Hospital Patients index 0-5) and 100 HCWs with high exposure to patient handling (MAPO index ≥ 5.01). As a negative control group, 200 visual display unit workers were also randomly selected. Musculoskeletal disorder cases were collected using a standardized case definition. A multivariate logistic regression analysis was performed comparing the MSD prevalence in the 4 groups. The overall prevalence of MSD was 17% in the reference group and 28.3% for HCWs. HHWs and HCWs with MAPO index ≥ 5.01 had similar prevalence of neck pain (9% and 11%, respectively), whereas lumbosacral pain prevalence was higher in the HHWs group (31%), with similar results in residential HCWs groups (21% in MAPO index 0-5 group and 25% in MAPO index ≥ 5.01 group). HCWs of group MAPO index ≥ 5.01 and HHWs showed the higher prevalence of upper limb complaints, with a prevalence of 20% and 10%, respectively. In multivariate regression analysis, prevalence of MSD complaints was quite similar in HHWs (adjusted odds ratio (OR_adj) = 2.335, 95% confidence interval (CI): 1.318-4.138) and in HCWs of the group MAPO ≥ 5.01 (OR_adj = 2.729, 95% CI: 1.552-4.797). The prevalence of MSD in the examined HCWs was relatively high, with HHWs appearing as a particularly high-risk group for lumbosacral back pain. In higher exposed HCWs, upper-limb symptoms were particularly frequent, probably reflecting the different tasks required to manage residential and homebased patients. In conclusion, this study reaffirms the high prevalence of MSD in HHWs, seemly similar to high-risk residential groups. Int J Occup Med Environ Health 2017;30(2):291-304. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Gender differences in occupations and complaints of musculoskeletal symptoms: Representative sample of South Korean workers.

PubMed

Park, Jungsun; Han, Bo-Young; Kim, Yangho

2017-04-01

The present study examines gender differences in occupations, occupational hazards, and musculoskeletal symptoms in Korean workers. We performed a secondary analysis of data from the fourth Korean Working Conditions Survey (KWCS). Relative to "managers," men who were "craft and related trades workers," "equipment, machine operating and assembling workers," and in "elementary occupations" were more likely to report back pain (ORs: 2.08, 2.33, and 2.71, respectively); women who were "skilled agricultural, forestry, and fishery workers" were more likely to report back pain (OR: 3.96). Back pain was more likely to be reported in men exposed to "carrying/moving heavy loads," "painful/tiring postures," and "repetitive hand/arm movements" (ORs: 1.20, 2.26, and 1.28, respectively). Men and women workers differed in their reporting of ergonomic risk factors, and complaints of musculoskeletal symptoms. Am. J. Ind. Med. 60:342-349, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

MUSCULOSKELETAL SCREENING AND FUNCTIONAL TESTING: CONSIDERATIONS FOR BASKETBALL ATHLETES

PubMed Central

Markwick, William J.

2016-01-01

Background and Purpose Youth participation in basketball is on the rise, with basketball one of the top five participation sports in Australia. With increased participation there is a need for greater awareness of the importance of the pre-participation examination, including musculoskeletal screening and functional performance testing as part of a multidisciplinary approach to reducing the risk for future injuries. As majority of all basketball injuries affect the lower extremities, pre-participation musculoskeletal screening and functional performance testing should assess fundamental movement qualities throughout the kinetic chain with an emphasis on lower extremity force characteristics, specifically eccentric loading tasks. Thus, the purpose of this clinical commentary is to review the existing literature elucidating pre-participation musculoskeletal screening and functional performance tests that can be used as a framework for rehabilitation professionals in assessing basketball athletes’ readiness to safely perform the movement demands of their sport. Methods Relevant articles published between 2000 and 2016 using the search terms ‘musculoskeletal screening’, ‘functional testing’, ‘youth athletes’, and ‘basketball’ were identified using MEDLINE. From a basketball-specific perspective, several relevant musculoskeletal assessments were identified, including: the Functional Hop Test Combination, the Landing Error Scoring System, the Tuck Jump Assessment, the Weight-Bearing Lunge Test, and the Star Excursion Balance Test. Each of these assessments creates movement demands that allow for easy identification of inefficient and/or compensatory movement tendencies. A basic understanding of musculoskeletal deficits including bilateral strength and flexibility imbalances, lower crossed syndrome, and dominance-related factors are key components in determination of injury risk. Discussion Assessment of sport-specific movement demands through musculoskeletal screening and functional performance testing is essential for rehabilitation professionals to determine movement competency during performance of fundamental movements related to basketball performance. Youth athletes represent a unique population due to their developing musculoskeletal and neuromuscular systems and should undergo pre-participation musculoskeletal screening for identification of movement limitations. Such an approach to musculoskeletal screening and functional performance may assist in identifying injury risk and also be useful at the end of rehabilitation in determining readiness to return to sport models. Level of Evidence Level 5 PMID:27757291

MUSCULOSKELETAL SCREENING AND FUNCTIONAL TESTING: CONSIDERATIONS FOR BASKETBALL ATHLETES.

PubMed

Bird, Stephen P; Markwick, William J

2016-10-01

Youth participation in basketball is on the rise, with basketball one of the top five participation sports in Australia. With increased participation there is a need for greater awareness of the importance of the pre-participation examination, including musculoskeletal screening and functional performance testing as part of a multidisciplinary approach to reducing the risk for future injuries. As majority of all basketball injuries affect the lower extremities, pre-participation musculoskeletal screening and functional performance testing should assess fundamental movement qualities throughout the kinetic chain with an emphasis on lower extremity force characteristics, specifically eccentric loading tasks. Thus, the purpose of this clinical commentary is to review the existing literature elucidating pre-participation musculoskeletal screening and functional performance tests that can be used as a framework for rehabilitation professionals in assessing basketball athletes' readiness to safely perform the movement demands of their sport. Relevant articles published between 2000 and 2016 using the search terms 'musculoskeletal screening', 'functional testing', 'youth athletes', and 'basketball' were identified using MEDLINE. From a basketball-specific perspective, several relevant musculoskeletal assessments were identified, including: the Functional Hop Test Combination, the Landing Error Scoring System, the Tuck Jump Assessment, the Weight-Bearing Lunge Test, and the Star Excursion Balance Test. Each of these assessments creates movement demands that allow for easy identification of inefficient and/or compensatory movement tendencies. A basic understanding of musculoskeletal deficits including bilateral strength and flexibility imbalances, lower crossed syndrome, and dominance-related factors are key components in determination of injury risk. Assessment of sport-specific movement demands through musculoskeletal screening and functional performance testing is essential for rehabilitation professionals to determine movement competency during performance of fundamental movements related to basketball performance. Youth athletes represent a unique population due to their developing musculoskeletal and neuromuscular systems and should undergo pre-participation musculoskeletal screening for identification of movement limitations. Such an approach to musculoskeletal screening and functional performance may assist in identifying injury risk and also be useful at the end of rehabilitation in determining readiness to return to sport models. Level 5.

Impact of rest breaks on musculoskeletal discomfort of Chikan embroiderers of West Bengal, India: a follow up field study

PubMed Central

Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Mitra, Kalpita; Sahu, Subhashis; Gangopadhyay, Somnath

2016-01-01

Objectives: This study aimed to determine risk factors that predict musculoskeletal discomfort in Chikan embroiderers of West Bengal, India, and to compare the effect of two rest break schedules to reduce these symptoms. Methods: The Nordic musculoskeletal questionnaire was performed on 400 Chikan embroiderers at baseline containing questions on job autonomy, working behavior, and work stress factors. Relative risk was calculated to identify prognostic factors for musculoskeletal discomfort in different body regions. Two groups of workers received two rest break schedules for 4 months and compared in a between-subject design. Outcome variables were scores of Body Part Discomfort (BPD) scale. Results: Chikan embroiderers are afflicted with musculoskeletal discomfort mainly in the lower back, neck/shoulder and wrist/forearm region, which is attributed to their prolonged working timeinvolving hands and wrists, being in a static seating posture. Rigidity in working methods, prolonged working time, inadequate rest break during the working day, dissatisfaction regarding earning, monotonous work, static sitting posture, and repetitive movement of wrist and forearm were the significant predictors of these symptom developments. Rest break schedule 1 with more frequent and shorter breaks had more significant improvement on the severity of these musculoskeletal discomforts. Conclusions: Chikan embroiderers perform a highly dreary occupation and various ergonomics conditions work as predictors for developing musculoskeletal discomforts among them. Design of proper rest break schedule involving shorter and frequent breaks was competent for reducing these discomforts to a certain extent. PMID:27265529

Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke

PubMed Central

2013-01-01

Background Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training) affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Method Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP) and HYBRID (combined FTP and power training) in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome), upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Results Primary outcome: Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049), regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03). Secondary outcomes: A greater proportion of participants achieved minimally important differences (MID) following HYBRID vs. FTP (p = .03). MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05). Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p < .05) and effects were retained 6-months post-intervention (p’s < .05). EMG position threshold and burst duration were significantly reduced at fast speeds (≥120º/s) (p’s < 0.05) and passive torque was reduced post-washout (p < .05) following HYBRID. Conclusions Functional and neuromechanical gains were greater following HYBRID vs. FPT. Improved stretch reflex modulation and increased neuromuscular activation indicate potent neural adaptations. Importantly, no deleterious consequences, including exacerbation of spasticity or musculoskeletal complaints, were associated with HYBRID. These results contribute to an evolving body of contemporary evidence regarding the efficacy of high-intensity training in neurorehabilitation and the physiological mechanisms that mediate neural recovery. PMID:23336711

Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke.

PubMed

Patten, Carolynn; Condliffe, Elizabeth G; Dairaghi, Christine A; Lum, Peter S

2013-01-21

Repetitive task practice is argued to drive neural plasticity following stroke. However, current evidence reveals that hemiparetic weakness impairs the capacity to perform, and practice, movements appropriately. Here we investigated how power training (i.e., high-intensity, dynamic resistance training) affects recovery of upper-extremity motor function post-stroke. We hypothesized that power training, as a component of upper-extremity rehabilitation, would promote greater functional gains than functional task practice without deleterious consequences. Nineteen chronic hemiparetic individuals were studied using a crossover design. All participants received both functional task practice (FTP) and HYBRID (combined FTP and power training) in random order. Blinded evaluations performed at baseline, following each intervention block and 6-months post-intervention included: Wolf Motor Function Test (WMFT-FAS, Primary Outcome), upper-extremity Fugl-Meyer Motor Assessment, Ashworth Scale, and Functional Independence Measure. Neuromechanical function was evaluated using isometric and dynamic joint torques and concurrent agonist EMG. Biceps stretch reflex responses were evaluated using passive elbow stretches ranging from 60 to 180º/s and determining: EMG onset position threshold, burst duration, burst intensity and passive torque at each speed. Improvements in WMFT-FAS were significantly greater following HYBRID vs. FTP (p = .049), regardless of treatment order. These functional improvements were retained 6-months post-intervention (p = .03). A greater proportion of participants achieved minimally important differences (MID) following HYBRID vs. FTP (p = .03). MIDs were retained 6-months post-intervention. Ashworth scores were unchanged (p > .05). Increased maximal isometric joint torque, agonist EMG and peak power were significantly greater following HYBRID vs. FTP (p < .05) and effects were retained 6-months post-intervention (p's < .05). EMG position threshold and burst duration were significantly reduced at fast speeds (≥120º/s) (p's < 0.05) and passive torque was reduced post-washout (p < .05) following HYBRID. Functional and neuromechanical gains were greater following HYBRID vs. FPT. Improved stretch reflex modulation and increased neuromuscular activation indicate potent neural adaptations. Importantly, no deleterious consequences, including exacerbation of spasticity or musculoskeletal complaints, were associated with HYBRID. These results contribute to an evolving body of contemporary evidence regarding the efficacy of high-intensity training in neurorehabilitation and the physiological mechanisms that mediate neural recovery.

Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: A 9-month prospective study

PubMed Central

Larsson, Agneta; Karlqvist, Lena; Gard, Gunvor

2008-01-01

Background Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health – a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector. Methods The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (n = 21) and an ergonomic education intervention (n = 21). Data were obtained by a self-report questionnaire on health- and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed. Results Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies. Conclusion Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change. PMID:18644154

Effect of an office ergonomic randomised controlled trial among workers with neck and upper extremity pain.

PubMed

Dropkin, Jonathan; Kim, Hyun; Punnett, Laura; Wegman, David H; Warren, Nicholas; Buchholz, Bryan

2015-01-01

Office computer workers are at increased risk for neck/upper extremity (UE) musculoskeletal pain. A seven-month office ergonomic intervention study evaluated the effect of two engineering controls plus training on neck/UE pain and mechanical exposures in 113 computer workers, including a 3-month follow-up period. Participants were randomised into an intervention group, who received a keyboard/mouse tray (KBT), touch pad (TP) for the non-dominant hand and keyboard shortcuts, and a control group who received keyboard shortcuts. Participants continued to have available a mouse at the dominant hand. Outcomes were pain severity, computer rapid upper limb assessment (RULA), and hand activity level. Prevalence ratios (PRs) evaluated intervention effects using dichotomised pain and exposure scores. In the intervention group, the dominnt proximal UE pain PR=0.9, 95% CI 0.7 to 1.2 and the dominant distal UE PR=0.8, 95% CI 0.5 to 1.3, postintervention. The non-dominant proximal UE pain PR=1.0, 95% CI 0.8 to 1.4, while the non-dominant distal UE PR=1.2, 95% CI 0.6 to 2.2, postintervention. Decreases in non-neutral postures were found in two RULA elements (non-dominant UE PR=0.9, 95% CI 0.8 to 0.9 and full non-dominant RULA PR=0.8, 95% CI 0.8 to 0.9) of the intervention group. Hand activity increased on the non-dominant side (PR=1.4, 95% CI 1.2 to 1.6) in this group. While the intervention reduced non-neutral postures in the non-dominant UE, it increased hand activity in the distal region of this extremity. To achieve lower hand activity, a KBT and TP used in the non-dominant hand may not be the best devices to use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Flap choice does not affect complication rates or functional outcomes following extremity soft tissue sarcoma reconstruction.

PubMed

Slump, Jelena; Hofer, Stefan O P; Ferguson, Peter C; Wunder, Jay S; Griffin, Anthony M; Hoekstra, Harald J; Bastiaannet, Esther; O'Neill, Anne C

2018-04-12

Flap reconstruction plays an essential role in facilitating limb preservation in patients with extremity soft tissue sarcoma (ESTS). However, the effect of flap choice on the rates of postoperative complications and functional outcomes has not been clearly established. This study directly compares the outcomes of free and pedicled flap reconstructions in patients with ESTS. Two hundred sixty-six patients who underwent flap reconstruction following ESTS resection were included. Associations between flap type and complications were determined using logistic regression analyses. Functional outcome was evaluated using the Toronto Extremity Salvage Score (TESS) and the Musculoskeletal Tumor Society Scales (MSTS). There was no significant difference between complication rates in the pedicled and free flap groups (32% vs. 38%, p = 0.38). In the lower limb, pedicled flaps had complication rates similar to those of free flaps on univariate analysis (odds ratio [OR] = 1.12, 95% confidence interval [CI] = 0.56-2.26, p = 0.75). Conversely, in the upper limb, pedicled flaps were associated with fewer complications on univariate analysis (OR = 0.31, 95% CI = 0.11-0.86, p = 0.03), but this was not significant on multivariate analysis (OR = 0.45, 95% CI = 0.13-1.59, p = 0.22). Obesity was a strong predictor of complications in the upper limb group on multivariate analysis (body mass index [BMI] ≥ 30 kg/m 2 , OR = 7.01, 95% CI = 1.28-38.51, p = 0.03). There was no significant difference in functional outcomes between both flap groups in either upper or lower limbs. Postoperative complications and functional outcomes for patients undergoing free and pedicled flaps are similar in ESTS reconstruction. Selecting the most suitable reconstructive option in each individual case is paramount to preserving function while minimizing postoperative morbidity. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Physical Activity Level and Sport Participation in Relation to Musculoskeletal Pain in a Population-Based Study of Adolescents

PubMed Central

Guddal, Maren Hjelle; Stensland, Synne Øien; Småstuen, Milada Cvancarova; Johnsen, Marianne Bakke; Zwart, John-Anker; Storheim, Kjersti

2017-01-01

Background: Prevalence of musculoskeletal pain among adolescents is high, and pain in adolescence increases the risk of chronic pain in adulthood. Studies have shown conflicting evidence regarding associations between physical activity and musculoskeletal pain, and few have evaluated the potential impact of sport participation on musculoskeletal pain in adolescent population samples. Purpose: To examine the associations between physical activity level, sport participation, and musculoskeletal pain in the neck and shoulders, low back, and lower extremities in a population-based sample of adolescents. Study Design: Cross-sectional study; Level of evidence 4. Methods: Data from the Nord-Trøndelag Health Study (Young-HUNT3) were used. All 10,464 adolescents in the Nord-Trøndelag county of Norway were invited, of whom 74% participated. Participants were asked how often they had experienced pain, unrelated to any known disease or acute injury, in the neck and shoulders, low back, and lower extremities in the past 3 months. The associations between (1) physical activity level (low [reference], medium or high) or (2) sport participation (weekly compared with no/infrequent participation) and pain were evaluated using logistic regression analyses, stratified by sex, and adjusted for age, socioeconomic status, and psychological distress. Results: The analyses included 7596 adolescents (mean age, 15.8 years; SD, 1.7). Neck and shoulder pain was most prevalent (17%). A moderate level of physical activity was associated with reduced odds of neck and shoulder pain (OR = 0.79 [95% CI, 0.66-0.94]) and low back pain (OR = 0.75 [95% CI, 0.62-0.91]), whereas a high level of activity increased the odds of lower extremity pain (OR = 1.60 [95% CI, 1.29-1.99]). Participation in endurance sports was associated with lower odds of neck and shoulder pain (OR = 0.79 [95% CI, 0.68-0.92]) and low back pain (OR = 0.77 [95% CI, 0.65-0.92]), especially among girls. Participation in technical sports was associated with increased odds of low back pain, whereas team sports were associated with increased odds of lower extremity pain. Strength and extreme sports were related to pain in all regions. Conclusion: We found that a moderate physical activity level was associated with less neck and shoulder pain and low back pain, and that participation in endurance sports may be particularly beneficial. Our findings highlight the need for health care professionals to consider the types of sports adolescents participate in when evaluating their musculoskeletal pain. PMID:28203603

Identification of potential neuromotor mechanisms of manual therapy in patients with musculoskeletal disablement: rationale and description of a clinical trial.

PubMed

Fisher, Beth E; Davenport, Todd E; Kulig, Kornelia; Wu, Allan D

2009-05-21

Many health care practitioners use a variety of hands-on treatments to improve symptoms and disablement in patients with musculoskeletal pathology.Research to date indirectly suggests a potentially broad effect of manual therapy on the neuromotor processing of functional behavior within the supraspinal central nervous system (CNS) in a manner that may be independent of modification at the level of local spinal circuits. However, the effect of treatment speed, as well as the specific mechanism and locus of CNS changes, remain unclear. We developed a placebo-controlled, randomized study to test the hypothesis that manual therapy procedures directed to the talocrural joint in individuals with post-acute ankle sprain induce a change in corticospinal excitability that is relevant to improve the performance of lower extremity functional behavior. This study is designed to identify potential neuromotor changes associated with manual therapy procedures directed to the appendicular skeleton, compare the relative effect of treatment speed on potential neuromotor effects of manual therapy procedures, and determine the behavioral relevance of potential neuromotor effects of manual therapy procedures. http://www.clinicaltrials.gov identifier NCT00847769.

Identification of potential neuromotor mechanisms of manual therapy in patients with musculoskeletal disablement: rationale and description of a clinical trial

PubMed Central

Fisher, Beth E; Davenport, Todd E; Kulig, Kornelia; Wu, Allan D

2009-01-01

Background Many health care practitioners use a variety of hands-on treatments to improve symptoms and disablement in patients with musculoskeletal pathology. Research to date indirectly suggests a potentially broad effect of manual therapy on the neuromotor processing of functional behavior within the supraspinal central nervous system (CNS) in a manner that may be independent of modification at the level of local spinal circuits. However, the effect of treatment speed, as well as the specific mechanism and locus of CNS changes, remain unclear. Methods/Design We developed a placebo-controlled, randomized study to test the hypothesis that manual therapy procedures directed to the talocrural joint in individuals with post-acute ankle sprain induce a change in corticospinal excitability that is relevant to improve the performance of lower extremity functional behavior. Discussion This study is designed to identify potential neuromotor changes associated with manual therapy procedures directed to the appendicular skeleton, compare the relative effect of treatment speed on potential neuromotor effects of manual therapy procedures, and determine the behavioral relevance of potential neuromotor effects of manual therapy procedures. Trial Registration identifier NCT00847769. PMID:19460169

Prevalence and Associated Factors for Musculoskeletal Pain and Disability Among Spanish Music Conservatory Students.

PubMed

Rodríguez-Romero, Beatriz; Pérez-Valiño, Coral; Ageitos-Alonso, Beatriz; Pértega-Díaz, Sonia

2016-12-01

To assess the prevalence of and factors associated with musculoskeletal pain (MSP) and neck and upper limb disability among music conservatory students. An observational study in two Spanish conservatories, investigating a total of 206 students, administered the Nordic Musculoskeletal Questionnaire, visual analog scale for pain intensity, Neck Disability Index, DASH, and SF-36. Demographic and lifestyle characteristics and musical performance variables were recorded. Regression models were performed to identify variables associated with MSP for the four most affected anatomical regions and with neck and upper limb disability. The locations with the highest prevalence of MSP were the neck, upper back, shoulders, and lower back. Mild disability affected 47% of participants in the neck and 31% in the upper limbs. Mental health (SF-36) was below the average for the general population (45.5±10.2). Women were more likely to suffer neck pain (odds ratio [OR] 1.1-5.2), lower back pain (OR 1.7-8.7), and neck disability (B 0.6-7.8). The risk for shoulder pain was higher in those who played for more hours (OR 1.7-24.7) and lower among those who performed physical activity (OR 0.23-1.00). Disability in the neck (B -0.3) and upper limbs (B -0.4) was associated with poorer mental health (SF-36). MSP is highly prevalent in music students. Neck and upper limb disability were slight to moderate and both were associated with poorer mental health. The main factors associated with MSP were being female, hours spent practicing, and physical activity. Physical and psychological factors should be taken into account in the prevention of MSP in student-musicians.

Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.

PubMed

von Piekartz, Harry; Pudelko, Ani; Danzeisen, Mira; Hall, Toby; Ballenberger, Nikolaus

2016-12-01

There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. Cross-sectional survey. Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy: does pain site matter?

PubMed

de Vos Andersen, Nils-Bo; Kent, Peter; Hjort, Jakob; Christiansen, David Høyrup

2017-03-29

Danish patients with musculoskeletal disorders are commonly referred for primary care physiotherapy treatment but little is known about their general health status, pain diagnoses, clinical course and prognosis. The objectives of this study were to 1) describe the clinical course of patients with musculoskeletal disorders referred to physiotherapy, 2) identify predictors associated with a satisfactory outcome, and 3) determine the influence of the primary pain site diagnosis relative to those predictors. This was a prospective cohort study of patients (n = 2,706) newly referred because of musculoskeletal pain to 30 physiotherapy practices from January 2012 to May 2012. Data were collected via a web-based questionnaire 1-2 days prior to the first physiotherapy consultation and at 6 weeks, 3 and 6 months, from clinical records (including primary musculoskeletal symptom diagnosis based on the ICPC-2 classification system), and from national registry data. The main outcome was the Patient Acceptable Symptom State. Potential predictors were analysed using backwards step-wise selection during longitudinal Generalised Estimating Equation regression modelling. To assess the influence of pain site on these associations, primary pain site diagnosis was added to the model. Of the patients included, 66% were female and the mean age was 48 (SD 15). The percentage of patients reporting their symptoms as acceptable was 32% at 6 weeks, 43% at 3 months and 52% at 6 months. A higher probability of satisfactory outcome was associated with place of residence, being retired, no compensation claim, less frequent pain, shorter duration of pain, lower levels of disability and fear avoidance, better mental health and being a non-smoker. Primary pain site diagnosis had little influence on these associations, and was not predictive of a satisfactory outcome. Only half of the patients rated their symptoms as acceptable at 6 months. Although satisfactory outcome was difficult to predict at an individual patient level, there were a number of prognostic factors that were associated with this outcome. These factors should be considered when developing generic prediction tools to assess the probability of satisfactory outcome in musculoskeletal physiotherapy patients, because the site of pain did not affect that prognostic association.

Reoperations following combat-related upper-extremity amputations.

PubMed

Tintle, Scott M; Baechler, Martin F; Nanos, George P; Forsberg, Jonathan A; Potter, Benjamin K

2012-08-15

Amputation revision rates following major upper-extremity amputations have not been previously reported in a large cohort of patients. We hypothesized that the revision rates following major upper-extremity amputation were higher than the existing literature would suggest, and that surgical treatment of complications and persistent symptoms would lead to improved outcomes. We performed a retrospective analysis of a consecutive series of ninety-six combat-wounded personnel who had sustained a total of 100 major upper-extremity amputations in Operation Iraqi Freedom and Operation Enduring Freedom. Prerevision and postrevision outcome measures, including prosthesis use and type, the presence of phantom and residual limb pain, pain medication use, and return to active military duty, were identified for all patients. All amputations resulted from high-energy trauma, with 87% occurring secondary to a blast injury. Forty-two residual limbs (42%) underwent a total of 103 repeat surgical interventions. As compared with patients with all other levels of amputation, those with a transradial amputation were 4.7 (95% confidence interval [CI]: 1.75 to 12.46) times more likely to have phantom limb pain and 2.8 (95% CI: 1.04 to 7.39) times more likely to require neuropathic pain medications. In the group of patients who underwent revision surgery, regular prosthesis use increased from 19% before the revision to 87% after it (p < 0.0001). In our cohort, revision amputation to address surgical complications and persistently symptomatic residual limbs improved the patient's overall acceptance of the prosthesis and led to outcomes equivalent to those following amputations that did not require revision.

Immediate effects of plantar inputs on the upper half muscles and upright posture: a preliminary study.

PubMed

Ciuffolo, Fabio; Ferritto, Anna L; Muratore, Filippo; Tecco, Simona; Testa, Mauro; D'Attilio, Michele; Festa, Felice

2006-01-01

This purpose of this study was to investigate the immediate effects of plantar inputs on both the upper half muscle activity (anterior temporal, masseter, digastric, sternocleidomastoid, upper and lower trapezius, cervical) and the body posture, by means of electromyography (EMG) and vertical force platform, respectively. Twenty four (24) healthy adults, between the ages of 24 and 31 years (25.3 +/- 1.9), with no history of craniomandibular disorder or systemic musculoskeletal dysfunction, were randomly divided into two groups: test group (fourteen subjects) and control group (ten subjects). A first recording session (TO) measured the baseline EMG and postural patterns of both groups. After this session, the test group wore test shoes with insoles that stimulated the plantar surfaces, while the control group wore placebo shoes. After one hour, a second set of measurements (T1) were performed. Significant differences between the groups at baseline were observed in the left anterior temporal, left cervical, and left upper trapezius, as well as at T1 in the left anterior temporal and right upper trapezius (p < 0.05). Within-test group analysis showed a significant increase of the right upper trapezius activity (p < 0.05), whereas no changes were found by within-control group analysis. Lower risk of asymmetric muscle patterns and postural blindness in the test group compared to the control group was observed. Further studies are warranted to investigate the short and long-term effects of this type of insole, in patients with both craniomandibular-cervical and lower extremity disorders.

Supervisor behaviour and its associations with employees' health in Europe.

PubMed

Montano, Diego

2016-02-01

To estimate the magnitude of the associations between different facets of supervisor behaviour and several health-related outcomes, and to assess whether these associations are mediated by known occupational health factors. Cross-sectional data from the European Working Conditions Survey were analysed by generalised linear mixed models (n = 32,770). Six regression models were estimated. Dependent variables include musculoskeletal (upper body, lower limbs, backache) and psychosomatic symptoms (stress and self-assessed general health). Independent variables correspond to several facets of supervisor behaviours such as supervisor support, feedback on work, ability to solve conflicts, encouragement to participate in decisions, and known occupational risk and protective factors. Even though supervisor behaviour is mediated by several known occupational risk factors, it still accounts for a substantial proportion of explained variance. The order of magnitude of associations was comparable to the strength of associations of known occupational risk factors. Odds ratios vary from 0.79 95% CI [0.73-0.86] to 1.12 95% CI [0.97-1.29] for dichotomous dependent variables. Regression coefficients vary from -0.22 95% CI [-0.28 to -0.17] to 0.07 95% CI [0.04-0.10] for metric dependent variables. Results suggest that good conflict solving skills, supervisor's work-planning ability, and a participative leadership style have the strongest predictive power regarding all health-related outcomes considered. Supervisor behaviour seems to play a non-negligible role from an occupational health perspective concerning the prevalence of musculoskeletal and psychosomatic symptoms. Results suggest that supervisor behaviour should be routinely assessed and monitored, especially among occupational groups reporting a lower quality of supervisor behaviours.

Hard work never hurt anyone: or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb.

PubMed

Walker-Bone, K; Cooper, C

2005-10-01

Pain in the neck and upper limb is common and contributes considerably to absence from work due to sickness. Evidence suggest that prolonged abnormal posture and repetition contribute to such conditions. Psychosocial risk factors may also play a part in the aetiology of upper limb disorders.

From an urologist view: are we safe with endoscopic surgery? Overview of ergonomic problems encountered by the urologist during video endoscopic surgery.

PubMed

Sataa, Sallami; Benzarti, Aida; Ben Jemaa, Abdelmajid

2012-12-01

The importance of minimally invasive surgery in urology has constantly increased in the last 20 years. Endoscopic resection of prostate and bladder tumors is actually a gold standard with many advantages for patients. To analyze the problems related to the ergonomic conditions faced by urologist during video endoscopic surgery by review of the recent literature. All evidence-based experimental ergonomic studies conducted in the fields of urology endoscopic surgery and applied ergonomics for other professions working with a display were identified by PubMed searches. Data from ergonomic studies were evaluated in terms of efficiency as well as comfort and safety aspects. Constraint postures for urologists are described and ergonomic requirements for optimal positions are discussed. The ergonomics of urological endoscopic surgery place urologists at risk for potential injury. The amount of neck flexion or extension, the amount of shoulder girdle adduction or abduction used, and stability of the upper extremities during surgery; which are maintained in a prolonged static posture; are the main risk factors. All these constraints may lead to muscle and joint fatigue, pain, and eventual musculoskeletal injury. Moreover, these issues may impact surgical accuracy. Urologist posture, operating period, training are important ergonomic factor during video surgery to prevent musculoskeletal disorders.

Musculoskeletal model-based control interface mimics physiologic hand dynamics during path tracing task

NASA Astrophysics Data System (ADS)

Crouch, Dustin L.; (Helen Huang, He

2017-06-01

Objective. We investigated the feasibility of a novel, customizable, simplified EMG-driven musculoskeletal model for estimating coordinated hand and wrist motions during a real-time path tracing task. Approach. A two-degree-of-freedom computational musculoskeletal model was implemented for real-time EMG-driven control of a stick figure hand displayed on a computer screen. After 5-10 minutes of undirected practice, subjects were given three attempts to trace 10 straight paths, one at a time, with the fingertip of the virtual hand. Able-bodied subjects completed the task on two separate test days. Main results. Across subjects and test days, there was a significant linear relationship between log-transformed measures of accuracy and speed (Pearson’s r  =  0.25, p  <  0.0001). The amputee subject could coordinate movement between the wrist and MCP joints, but favored metacarpophalangeal joint motion more highly than able-bodied subjects in 8 of 10 trials. For able-bodied subjects, tracing accuracy was lower at the extremes of the model’s range of motion, though there was no apparent relationship between tracing accuracy and fingertip location for the amputee. Our result suggests that, unlike able-bodied subjects, the amputee’s motor control patterns were not accustomed to the multi-joint dynamics of the wrist and hand, possibly as a result of post-amputation cortical plasticity, disuse, or sensory deficits. Significance. To our knowledge, our study is one of very few that have demonstrated the real-time simultaneous control of multi-joint movements, especially wrist and finger movements, using an EMG-driven musculoskeletal model, which differs from the many data-driven algorithms that dominate the literature on EMG-driven prosthesis control. Real-time control was achieved with very little training and simple, quick (~15 s) calibration. Thus, our model is potentially a practical and effective control platform for multifunctional myoelectric prostheses that could restore more life-like hand function for individuals with upper limb amputation.

Subcutaneous oedema of upper limbs heralding an aggressive form of dermatomyositis.

PubMed

Shukla, Mohit; Patel, Rishi; Kuzyshyn, Halyna; Feinstein, David

2018-05-30

Subcutaneous oedema is a rare presenting clinical manifestation of dermatomyositis. In this case, we report a 44-year-old man presenting with bilateral upper extremity predominant swelling and weakness. The proximal muscle weakness, dysphagia and presence of Gottron's papules as well poikiloderma like skin changes led to the clinical diagnosis of dermatomyositis. He received aggressive treatment with high-dose glucocorticoids and required intravenous immunoglobulin with improvement in his symptoms. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Comorbidity and health-related quality of life in patients with severe chronic obstructive pulmonary disease attending Swedish secondary care units.

PubMed

Sundh, Josefin; Johansson, Gunnar; Larsson, Kjell; Lindén, Anders; Löfdahl, Claes-Göran; Janson, Christer; Sandström, Thomas

2015-01-01

Our understanding of how comorbid diseases influence health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) is limited and in need of improvement. The aim of this study was to examine the associations between comorbidities and HRQL as measured by the instruments EuroQol-5 dimension (EQ-5D) and the COPD Assessment Test (CAT). Information on patient characteristics, chronic bronchitis, cardiovascular disease, diabetes, renal impairment, musculoskeletal symptoms, osteoporosis, depression, and EQ-5D and CAT questionnaire results was collected from 373 patients with Forced Expiratory Volume in one second (FEV1) <50% of predicted value from 27 secondary care respiratory units in Sweden. Correlation analyses and multiple linear regression models were performed using EQ-5D index, EQ-5D visual analog scale (VAS), and CAT scores as response variables. Having more comorbid conditions was associated with a worse HRQL as assessed by all instruments. Chronic bronchitis was significantly associated with a worse HRQL as assessed by EQ-5D index (adjusted regression coefficient [95% confidence interval] -0.07 [-0.13 to -0.02]), EQ-5D VAS (-5.17 [-9.42 to -0.92]), and CAT (3.78 [2.35 to 5.20]). Musculoskeletal symptoms were significantly associated with worse EQ-5D index (-0.08 [-0.14 to -0.02]), osteoporosis with worse EQ-5D VAS (-4.65 [-9.27 to -0.03]), and depression with worse EQ-5D index (-0.10 [-0.17 to -0.04]). In stratification analyses, the associations of musculoskeletal symptoms, osteoporosis, and depression with HRQL were limited to female patients. The instruments EQ-5D and CAT complement each other and emerge as useful for assessing HRQL in patients with COPD. Chronic bronchitis, musculoskeletal symptoms, osteoporosis, and depression were associated with worse HRQL. We conclude that comorbid conditions, in particular chronic bronchitis, depression, osteoporosis, and musculoskeletal symptoms, should be taken into account in the clinical management of patients with severe COPD.

The Association of Workplace Psychosocial Factors and Musculoskeletal Pain Among Korean Emotional Laborers.

PubMed

Baek, Kiook; Yang, Seonhee; Lee, Miyoung; Chung, Insung

2018-06-01

Many studies have reported negative psychological or physical effects of emotional labor. Relationship between work-related musculoskeletal disorder and psychosocial factors has been reported. To manage organizational and psychosocial factors of musculoskeletal disorder with work place intervention among emotional laborers, the factors contributing to musculoskeletal pain must be identified and clarified. Data from the fourth Korean Working Conditions Survey was analyzed. Based on the questionnaire, we selected emotional laborers and included 3,979 participants, excluding participants whose variables were of interest to the researcher. Weight variable was applied. The association with musculoskeletal pain and psychosocial factors, such as workload, monotonous work, job control, social support, and job satisfaction, was investigated. Univariate analysis demonstrated that there was a statistically significant relationship between social support, job satisfaction, and musculoskeletal pain. In multivariate analysis, job satisfaction showed a strong correlation with musculoskeletal pain at all sites. Social support was significantly associated with backache. Monotonous work seemed to reduce the pain in the neck and/or upper limbs. Job control and work intensity were not significantly associated with musculoskeletal pain. In this study, job satisfaction was significantly associated with musculoskeletal pain, and social support among the social psychological stressors could reduce musculoskeletal pain. However, unlike previously known, the presence of monotonous work resulted in reduced musculoskeletal pain. The results of this study will help to establish the direction of improvement of atmosphere in the workplace to prevent the musculoskeletal pain of emotional laborers.

Efficacy of temporary work modifications on disability related to musculoskeletal pain or depressive symptoms—study protocol for a controlled trial

PubMed Central

Haukka, Eija; Martimo, Kari-Pekka; Kivekäs, Teija; Horppu, Ritva; Lallukka, Tea; Solovieva, Svetlana; Shiri, Rahman; Pehkonen, Irmeli; Takala, Esa-Pekka; MacEachen, Ellen; Viikari-Juntura, Eira

2015-01-01

Introduction Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms. Methods and analysis A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0–10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days during a 12-month follow-up. Secondary outcomes are intensity of musculoskeletal pain (scale 0–10), pain interference with work or sleep (scale 0–10) and severity of depressive symptoms (Patient Health Questionnaire, PHQ-9), inquired via online questionnaires at baseline and 3, 6, 9 and 12 months after recruitment. Information on SA days will be collected from the medical records of the OHSs over 12 months, before and after recruitment. The findings will give new information about the possibilities of training physicians to initiate work modifications and their effects on RTW in employees with work disability due to musculoskeletal pain or depressive symptoms. Ethics and dissemination The Coordinating Ethics Committee of Hospital District of Helsinki and Uusimaa has granted approval for this study. The results will be published in peer-reviewed journals. Trial registration number ISRCTN74743666. PMID:25986643

Effectiveness of job rotation for preventing work-related musculoskeletal diseases: a cluster randomised controlled trial.

PubMed

Comper, Maria Luiza Caires; Dennerlein, Jack Tigh; Evangelista, Gabriela Dos Santos; Rodrigues da Silva, Patricia; Padula, Rosimeire Simprini

2017-08-01

Job rotation is an organisational strategy widely used on assembly lines in manufacturing industries to mitigate workers' exposure so as to prevent musculoskeletal disorders. This study aimed to evaluate the effectiveness of job rotation for reducing working hours lost due to sick leave resulting from musculoskeletal diseases. The design consisted of a 1-year cluster randomised controlled trial with a blinded assessor. Production sectors of the textile industry were randomised to intervention and control groups. Both groups received ergonomic training. The intervention group performed a job rotation programme. The primary outcome measure was number of working hours lost due to sick leave as a result of musculoskeletal disease (ICD-10). The secondary outcome measures were musculoskeletal symptoms (Yes/No), risk factors for musculoskeletal diseases (0-10), psychosocial factors and fatigue (0-100), general health (0-100), and productivity (0-10). All secondary outcomes were measured at baseline and 12-month follow-up. At the 12-month follow-up, both groups showed an increase in the number of working hours lost due to sick leave for musculoskeletal disease. There was no significant difference between the job rotation intervention group (mean deviation -5.6 hours, 95% CI -25.0 to 13.8) at the 12-month follow-up and the control group. There were no significant differences between groups for the secondary outcomes (p>0.05). The job rotation programme was not effective in reducing the number of working hours lost due to sick leave, decreasing the prevalence of musculoskeletal symptoms, or improving perception of musculoskeletal pain and workplace risk factors, psychosocial risk factors and productivity. NCT01979731. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Functional incapacity related to rotator cuff syndrome in workers. Is it influenced by social characteristics and medical management?

PubMed

Champagne, Romain; Bodin, Julie; Fouquet, Natacha; Roquelaure, Yves; Petit, Audrey

2017-12-04

Survey. Rotator cuff syndrome (RCS) is one of the most common musculoskeletal disorders reported in workers. The functional incapacity related to RCS may vary according to the sociodemographic context and to the medical management. The purpose of this is to analyze the RCS-related functional incapacity assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires in workers according to their sociodemographic characteristics and the use of care. A cross-sectional study was carried out on a French sample of workers diagnosed with RCS. The DASH and DASH-work scores were studied according to the sociodemographic factors, musculoskeletal symptoms, and RCS medical management during the preceding 12 months. Two hundred seven workers who suffered from RCS filled out the questionnaire of which 80% were still working. The DASH score was significantly higher in women (24.0 vs 17.4; P < .01; effect size (d) = 0.39), in patients over the age of 50 years (23.6 vs 11.3; P < .005) and in case of another upper limb musculoskeletal disorder (P < .0001; d ≥ 0.4). The DASH and DASH-work scores were significantly higher in case of use of care for RCS (P < .005; d > 0.6). The demographic factors and the RCS medical management influenced the overall incapacity assessed by the DASH questionnaire. Work incapacity was more especially related to the use of care for RCS. The sociodemographic and medical parameters added to other established predictors could help guide clinicians in managing their patients. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions.

PubMed

Röijezon, Ulrik; Clark, Nicholas C; Treleaven, Julia

2015-06-01

Impaired proprioception has been reported as a feature in a number of musculoskeletal disorders of various body parts, from the cervical spine to the ankle. Proprioception deficits can occur as a result of traumatic damage, e.g., to ligaments and muscles, but can also occur in association with painful disorders of a gradual-onset nature. Muscle fatigue can also adversely affect proprioception and this has implications for both symptomatic and asymptomatic individuals. Due to the importance of proprioception for sensorimotor control, specific methods for assessment and training of proprioception have been developed for both the spine and the extremities. The aim of this first part of a two part series on proprioception in musculoskeletal rehabilitation is to present a theory based overview of the role of proprioception in sensorimotor control, assessment, causes and findings of altered proprioception in musculoskeletal disorders and general principles of interventions targeting proprioception. An understanding of the basic science of proprioception, consequences of disturbances and theories behind assessment and interventions is vital for the clinical management of musculoskeletal disorders. Part one of this series supplies a theoretical base for part two which is more practically and clinically orientated, covering specific examples of methods for clinical assessment and interventions to improve proprioception in the spine and the extremities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Traumeel – an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries

PubMed Central

Schneider, Christian

2011-01-01

Musculoskeletal injuries are on the rise. First-line management of such injuries usually employs the RICE (rest, ice, compression, and elevation) approach to limit excessive inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also commonly used to limit inflammation and to control pain. Traumeel®, a preparation with bioregulatory effects is also used to treat the symptoms associated with acute musculoskeletal injuries, including pain and swelling. Traumeel is a fixed combination of biological and mineral extracts, which aims to apply stimuli to multiple targets to restore normal functioning of regulatory mechanisms. This paper presents the accumulating evidence of Traumeel’s action on the inflammatory process, and of its efficacy and tolerability in randomized trials, as well as observational and surveillance studies for the treatment of musculoskeletal injuries. Traumeel has shown comparable effectiveness to NSAIDs in terms of reducing symptoms of inflammation, accelerating recovery, and improving mobility, with a favorable safety profile. While continued research and development is ongoing to broaden the clinical evidence of Traumeel in acute musculoskeletal injury and to further establish its benefits, current information suggests that Traumeel may be considered as an anti-inflammatory agent that is at least as effective and appears to be better tolerated than NSAIDs. PMID:21556350

Pediatric post-thrombotic syndrome in children: Toward the development of a new diagnostic and evaluative measurement tool.

PubMed

Avila, M L; Brandão, L R; Williams, S; Ward, L C; Montoya, M I; Stinson, J; Kiss, A; Lara-Corrales, I; Feldman, B M

2016-08-01

Our goal was to conduct the item generation and piloting phases of a new discriminative and evaluative tool for pediatric post-thrombotic syndrome. We followed a formative model for the development of the tool, focusing on the signs/symptoms (items) that define post-thrombotic syndrome. For item generation, pediatric thrombosis experts and subjects diagnosed with extremity post-thrombotic syndrome during childhood nominated items. In the piloting phase, items were cross-sectionally measured in children with limb deep vein thrombosis to examine item performance. Twenty-three experts and 16 subjects listed 34 items, which were then measured in 140 subjects with previous diagnosis of limb deep vein thrombosis (70 upper extremity and 70 lower extremity). The items with strongest correlation with post-thrombotic syndrome severity and largest area under the curve were pain (in older children), paresthesia, and swollen limb for the upper extremity group, and pain (in older children), tired limb, heaviness, tightness and paresthesia for the lower extremity group. The diagnostic properties of the items and their correlations with post-thrombotic syndrome severity varied according to the assessed venous territory. The information gathered in this study will help experts decide which item should be considered for inclusion in the new tool. Copyright © 2016 Elsevier Ltd. All rights reserved.

Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes.

PubMed

Skedros, John G; Smith, James S; Henrie, Marshall K; Finlinson, Ethan D; Trachtenberg, Joel D

2018-01-01

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.

Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes

PubMed Central

Smith, James S.; Henrie, Marshall K.; Finlinson, Ethan D.; Trachtenberg, Joel D.

2018-01-01

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis. PMID:29796328

Effectiveness of participatory training for prevention of musculoskeletal disorders: a randomized controlled trial.

PubMed

Yu, Wenzhou; Yu, Ignatius T S; Wang, Xiaorong; Li, Zhimin; Wan, Sabrina; Qiu, Hong; Lin, Hui; Xie, Shaohua; Sun, Trevor

2013-05-01

Health and safety training program has been applied to prevent work-related musculoskeletal disorders (MSDs) in workplace. We evaluated the effectiveness of participatory training and didactic training programs on MSD prevention among frontline workers in Shenzhen, China. The authors randomly assigned 918 workers from intervention factories to receive participatory training (intervention group), and 907 workers from intervention factories and 1,654 workers from control factories to receive didactic training (control_1 group, control_2 group, respectively) from June 1, 2008 to November 30, 2009. Participants were asked to report experience of ache, pain or discomfort in 10 body parts at baseline and 1 year after training. Data were analyzed to compare the MSD prevalence 1 year before and 1 year after training in different groups from 2009 to 2010. The follow-up rate was 61 % (2,120/3,479) at 1 year after training. In the year after training, there were no statistically significant changes in the proportion of workers who reported MSD in any body part. MSD prevalence rates in the intervention group reduced from 16.8 to 9.9 % for lower extremities (χ(2) = 13.102, p < 0.001) and from 12.9 to 8.3 % (χ(2) = 9.433, p = 0.002) for wrist and finger at 1 year after training. However, the rates did not change significantly for upper back, lower back, neck, shoulder and elbow in the intervention group and for all 10 body parts in two control groups. Overall, the training programs did not seem to prevent the occurrence of MSD among frontline workers. However, participatory training might be effective to reduce MSD in the lower extremities and wrist and finger.

An ergonomic intervention to reduce musculoskeletal discomfort among semiconductor assembly workers.

PubMed

Aghilinejad, Mashallah; Azar, Neda Soleimanvandy; Ghasemi, Mohammad Sadegh; Dehghan, Naser; Mokamelkhah, Elahe Kabir

2016-06-14

Work-related musculoskeletal disorders (MSDs) and ergonomics-related injuries are the single largest category of workplace injuries and are responsible for almost 30% of all worker's compensation costs. Awkward working posture refers to positions of the body that deviate significantly from the neutral position while job tasks are being performed and it is the primary ergonomic risk factor for developing musculoskeletal discomfort. This study was conducted among assembly workers of a semiconductor in Tehran province with the objective of implementing an interventional ergonomic program to minimize musculoskeletal discomfort. This study that was conducted on 105 male assembly workers of a semiconductor industry based on a census method. The standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to determine the prevalence of MSDs. Corlett and Bishop's body part discomfort scale (BPD) was applied to evaluate body discomfort before and after the intervention (using a magnifying loupes to improve visibility of the parts). The results of NMQ showed the highest rate of MSDs were in neck, shoulder, upper arm and lower back regions (more than 75%). After ergonomic intervention, significant decrements of discomfort was observed in neck, shoulder, upper arm, elbows, lower arm, lower back and whole body discomfort (p < 0.05). It can be concluded that using magnifying loupes reduced discomfort in different body regions and the whole body. A conclusion of this research is that ergonomic interventions can decrease MSDs of at risk body regions in the long term.

Optimizing Positioning for In-Office Otology Procedures.

PubMed

Govil, Nandini; DeMayo, William M; Hirsch, Barry E; McCall, Andrew A

2017-01-01

Objective Surgeons often report musculoskeletal discomfort in relation to their practice, but few understand optimal ergonomic positioning. This study aims to determine which patient position-sitting versus supine-is ergonomically optimal for performing otologic procedures. Study Design Observational study. Setting Outpatient otolaryngology clinic setting in a tertiary care facility. Subjects and Methods We observed 3 neurotologists performing a standardized simulated cerumen debridement procedure on volunteers in 2 positions: sitting and supine. The Rapid Upper Limb Assessment (RULA)-a validated tool that calculates stress placed on the upper limb during a task-was used to evaluate ergonomic positioning. Scores on this instrument range from 1 to 7, with a score of 1 to 2 indicating negligible risk of developing posture-related injury. The risk of musculoskeletal disorders increases as the RULA score increases. Results In nearly every trial, RULA scores were lower when the simulated patient was placed in the supine position. When examined as a group, the median RULA scores were 5 with the patient sitting and 3 with the patient in the supine position ( P < .0001). When the RULA scores of the 3 neurotologists were examined individually, each had a statistically significant decrease in score with the patient in the supine position. Conclusion This study indicates that patient position may contribute to ergonomic stress placed on the otolaryngologist's upper limb during in-office otologic procedures. Otolaryngologists should consider performing otologic procedures with the patient in the supine position to decrease their own risk of developing upper-limb musculoskeletal disorders.

Modified Graded Motor Imagery for Complex Regional Pain Syndrome Type 1 of the Upper Extremity in the Acute Phase: A Patient Series

ERIC Educational Resources Information Center

Lagueux, Emilie; Charest, Joelle; Lefrancois-Caron, Eve; Mauger, Marie-Eve; Mercier, Emilie; Savard, Kim; Tousignant-Laflamme, Yannick

2012-01-01

Complex regional pain syndrome (CRPS) is a pathologic condition in which the painful experience is disproportionate in time and intensity in comparison with the inciting event. At present, the pathophysiology of CRPS is not well understood. Several studies have indicated that cortical reorganization plays a role in the persistence of the symptoms.…

Carpal Tunnel Syndrome

PubMed Central

Zimmerman, Gregory R.

1994-01-01

Carpal tunnel syndrome is a neuropathy resulting from compression of the median nerve as it passes through a narrow tunnel in the wrist on its way to the hand. The lack of precise objective and clinical tests, along with symptoms that are synonymous with other syndromes in the upper extremity, cause carpal tunnel syndrome to appear to be a rare entity in athletics. However, it should not be ruled out as a possible etiology of upper extremity paralysis in the athlete. More typically, carpal tunnel syndrome is the most common peripheral entrapment neuropathy encountered in industry. Treatment may include rest and/or splinting of the involved wrist, ice application, galvanic stimulation, or iontophoresis to reduce inflammation, and then transition to heat modalities and therapeutic exercises for developing flexibility, strength, and endurance. In addition, an ergonomic assessment should be conducted, resulting in modifications to accommodate the carpal tunnel syndrome patient. ImagesFig 3.Fig 4.Fig 5.Fig 6.Fig 7. PMID:16558255

Accessory Muscles of the Extremities.

PubMed

Vanhoenacker, Filip M; Desimpel, Julie; Mespreuve, Marc; Tagliafico, Alberto

2018-07-01

Accessory muscles and variations are not uncommon at the upper and lower extremity. They are often overlooked because they are asymptomatic and present as incidental findings on imaging. However, they may present as a soft tissue swelling, thereby mimicking soft tissue tumors. Other symptoms are attributed to impingement on neurovascular structures and to exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of it are the clues to correct identification. On ultrasound, accessory muscles have a similar echotexture as other muscles, whereas the signal intensity on magnetic resonance imaging (MRI) is similar to muscle. Because of the intrinsic contrast with the adjacent intermuscular fat, accessory muscles are best depicted on MRI without fat suppression. This article provides a short overview of the anatomy of most prevalent accessory muscles of the upper and lower limb and its potential pathogenic nature. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effort Thrombosis Presenting as Pulmonary Embolism in a Professional Baseball Pitcher

PubMed Central

Bushnell, Brandon D.; Anz, Adam W.; Dugger, Keith; Sakryd, Gary A.; Noonan, Thomas J.

2009-01-01

Context: Effort thrombosis, or Paget-Schroetter’s syndrome, is a rare subset of thoracic outlet syndrome in which deep venous thrombosis of the upper extremity occurs as the result of repetitive overhead motion. It is occasionally associated with pulmonary embolism. This case of effort thrombosis and pulmonary embolus was in a 25-year-old major league professional baseball pitcher, in which the only presenting complaints involved dizziness and shortness of breath without complaints involving the upper extremity—usually, a hallmark of most cases of this condition. The patient successfully returned to play for 5 subsequent seasons at the major league level after multimodal treatment that included surgery for thoracic outlet syndrome. Objective: Though rare, effort thrombosis should be included in the differential diagnosis of throwing athletes with traditional extremity-focused symptoms and in cases involving pulmonary or thoracic complaints. Rapid diagnosis is a critical component of successful treatment. PMID:23015912

Syringomyelia with intramedullary ectopic choroid plexus: Case report.

PubMed

Duan, Hongzhou; Zhang, Jiayong; Xu, Feifan; Zhang, Zongqiang; Zhao, Xiaowen

2018-06-01

Intramedullary ectopic choroid plexus is rarely reported, here, we reported a rare case of symptomatic syringomyelia resulted of intramedullary ectopic choroid plexus. The patient was a 30-year-old female who presented with a 2-month history of progressive pain of upper back and bilateral ankle joint and progressive loss of upper-extremity function. MRI examination showed an intramedullary cystic lesion at T2-T4 without enhancement. Operative exploration was indicated. A reddish vascular villus-like lesion was found being located in the left dorsal part of the cyst, which was enblock removed and was confirmed as an ectopic choroid plexus tissue by pathological examination. The patient recovered uneventful and the symptom resolved during follow-up. Although ectopic choroid plexus is extremely rare, it should be taken into acount in the differential diagnosis of pathogenesis in syringomyelia or intramedullary cyst, aggressive surgical exploration should be considered when necessary. Copyright © 2018 Elsevier B.V. All rights reserved.

Inflammation and neuropathic attacks in hereditary brachial plexus neuropathy

PubMed Central

Klein, C; Dyck, P; Friedenberg, S; Burns, T; Windebank, A; Dyck, P

2002-01-01

Objective: To study the role of mechanical, infectious, and inflammatory factors inducing neuropathic attacks in hereditary brachial plexus neuropathy (HBPN), an autosomal dominant disorder characterised by attacks of pain and weakness, atrophy, and sensory alterations of the shoulder girdle and upper limb muscles. Methods: Four patients from separate kindreds with HBPN were evaluated. Upper extremity nerve biopsies were obtained during attacks from a person of each kindred. In situ hybridisation for common viruses in nerve tissue and genetic testing for a hereditary tendency to pressure palsies (HNPP; tomaculous neuropathy) were undertaken. Two patients treated with intravenous methyl prednisolone had serial clinical and electrophysiological examinations. One patient was followed prospectively through pregnancy and during the development of a stereotypic attack after elective caesarean delivery. Results: Upper extremity nerve biopsies in two patients showed prominent perivascular inflammatory infiltrates with vessel wall disruption. Nerve in situ hybridisation for viruses was negative. There were no tomaculous nerve changes. In two patients intravenous methyl prednisolone ameliorated symptoms (largely pain), but with tapering of steroid dose, signs and symptoms worsened. Elective caesarean delivery did not prevent a typical postpartum attack. Conclusions: Inflammation, probably immune, appears pathogenic for some if not all attacks of HBPN. Immune modulation may be useful in preventing or reducing the neuropathic attacks, although controlled trials are needed to establish efficacy, as correction of the mutant gene is still not possible. The genes involved in immune regulation may be candidates for causing HBPN disorders. PMID:12082044

Effects of virtual reality-based bilateral upper-extremity training on brain activity in post-stroke patients.

PubMed

Lee, Su-Hyun; Kim, Yu-Mi; Lee, Byoung-Hee

2015-07-01

[Purpose] This study investigated the therapeutic effects of virtual reality-based bilateral upper-extremity training on brain activity in patients with stroke. [Subjects and Methods] Eighteen chronic stroke patients were divided into two groups: the virtual reality-based bilateral upper-extremity training group (n = 10) and the bilateral upper-limb training group (n = 8). The virtual reality-based bilateral upper-extremity training group performed bilateral upper-extremity exercises in a virtual reality environment, while the bilateral upper-limb training group performed only bilateral upper-extremity exercise. All training was conducted 30 minutes per day, three times per week for six weeks, followed by brain activity evaluation. [Results] Electroencephalography showed significant increases in concentration in the frontopolar 2 and frontal 4 areas, and significant increases in brain activity in the frontopolar 1 and frontal 3 areas in the virtual reality-based bilateral upper-extremity training group. [Conclusion] Virtual reality-based bilateral upper-extremity training can improve the brain activity of stroke patients. Thus, virtual reality-based bilateral upper-extremity training is feasible and beneficial for improving brain activation in stroke patients.

Dental ergonomics to combat musculoskeletal disorders: a review.

PubMed

Gupta, Arpit; Ankola, Anil V; Hebbal, Mamata

2013-01-01

Musculoskeletal disorders (MSDs) are significant workplace problems affecting occupational health, productivity and the careers of dental professionals. The prevalence of MSDs is on the rise for all types of dental workers. In spite of different patterns of work culture, there are parallel levels of symptoms in dentists across nations. Risk factors for MSDs are multifactorial. Symptoms appear very early in careers, with higher prevalence of MSDs even during educational training. Ergonomics improvements, health promotion and organizational interventions are necessary to reduce the risk. An interdisciplinary approach with progressive efforts should be taken to address MSDs in dental professionals.

Malpractice claims related to musculoskeletal imaging. Incidence and anatomical location of lesions.

PubMed

Fileni, Adriano; Fileni, Gaia; Mirk, Paoletta; Magnavita, Giulia; Nicoli, Marzia; Magnavita, Nicola

2013-12-01

Failure to detect lesions of the musculoskeletal system is a frequent cause of malpractice claims against radiologists. We examined all the malpractice claims related to alleged errors in musculoskeletal imaging filed against Italian radiologists over a period of 14 years (1993-2006). During the period considered, a total of 416 claims for alleged diagnostic errors relating to the musculoskeletal system were filed against radiologists; of these, 389 (93.5%) concerned failure to report fractures, and 15 (3.6%) failure to diagnose a tumour. Incorrect interpretation of bone pathology is among the most common causes of litigation against radiologists; alone, it accounts for 36.4% of all malpractice claims filed during the observation period. Awareness of this risk should encourage extreme caution and diligence.

Musculoskeletal disorder survey for pond workers

NASA Astrophysics Data System (ADS)

Maryani, A.; Partiwi, S. G.; Dewi, H. N. F.

2018-04-01

Mucsuloskeletal disorder will affect worker performance and become serious injury when ignored, so that workers cannot work normally. Therefore, an effective strategy plan is needed to reduce the risk of musculoskeletal disorder. A pond worker is profession with high risk of physical complain. Four main activities are ponds preparation, seed distribution, pond maintenance, and harvesting. The methods employed in this current musculoskeletal disorder survey are questionnaire and interview. The result from 73 questionnaires shown that most of pond workers were working for 7 days a week. Prevalence physical complain are on neck, shoulders, upper back, lower back, and knees. The level of perceived complaint is moderate pain. However, most of them do not contact therapists or physicians. Therefore it is necessary to improve the working methods to be able to reduce physical complains due to musculoskeletal disorder.

Mobile technology dominates school children's IT use in an advantaged school community and is associated with musculoskeletal and visual symptoms.

PubMed

Straker, Leon; Harris, Courtenay; Joosten, John; Howie, Erin K

2018-05-01

This paper describes the contemporary use of information technology devices by children in a socio-educationally advantaged school. A sample of 924 children (50% girls) from grades 5 to 12 (ages 10-19 years) completed an online survey in class. Total daily technology use was high and similar for girls (mean 219 (SD 148) mins/day) and boys (207 (142), p=.186). Tablet computer was the dominant device used in grades 5-9, with laptop computer the dominant device in grades 10-12. Patterns of exposure were influenced by gender, device, grade and purpose of use interactions. For example, girls used mobile phones more than boys for social purposes for grades 10 and 11, but not grade 12. Whilst children's attitudes to technology use were positive, musculoskeletal and visual symptoms were commonly reported. Hours/day tablet and phone use was related to neck/shoulder discomfort (OR = 1.07; 1.13) and visual symptoms (OR = 1.10; 1.07). Practitioner Summary: Technology use by children appears to be quite different now to a decade ago. This paper describes contemporary school children's use of various devices for various purposes. The survey of >900 children found high technology use, dominated by new mobile technologies, and associations with musculoskeletal and visual symptoms.

Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work.

PubMed

Ahlgren, Christina; Malmgren Olsson, Eva-Britt; Brulin, Christine

2012-01-01

The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men. The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.

The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion

PubMed Central

2012-01-01

Background The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. Methods Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. Results The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects. Conclusions The rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration. PMID:23173938

The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion.

PubMed

Tsai, Chung-Ying; Lin, Chien-Ju; Huang, Yueh-Chu; Lin, Po-Chou; Su, Fong-Chin

2012-11-22

The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects. The rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration.

Multidisciplinary Intervention in Patients with Musculoskeletal Pain: a Randomized Clinical Trial.

PubMed

Brendbekken, Randi; Harris, Anette; Ursin, Holger; Eriksen, Hege R; Tangen, Tone

2016-02-01

Musculoskeletal pain is associated with comorbidity, extensive use of health services, long-term disability and reduced quality of life. The scientific literature on effects of treatment for musculoskeletal pain is inconclusive. The purpose of this study is to compare a multidisciplinary intervention (MI), including use of the novel Interdisciplinary Structured Interview with a Visual Educational Tool (ISIVET), with a brief intervention (BI), on effects on mental and physical symptoms, functioning ability, use of health services and coping in patients sick-listed due to musculoskeletal pain. Two hundred eighty-four adults aged 18-60, referred to a specialist clinic in physical rehabilitation, were randomized to MI or BI. Patients received a medical examination at baseline and completed a comprehensive questionnaire at baseline, 3 months and 12 months. Both groups reported improvements in mental and physical symptoms, including pain, and improved functioning ability at 3 and 12 months, but the MI group improved faster than the BI group except from reports of pain, which had a similar course. Significant interactions between group and time were found on mental symptoms (anxiety (p < 0.05), depression (p < 0.01), somatization (p < 0.01)) and functioning ability (p < 0.01) due to stronger effects in the MI group at 3 months. At 3 and 12 months, the MI group reported significantly less use of health services (general practitioner (p < 0.05)). At 12 months, the MI group reported better self-evaluated capability of coping with complaints (p < 0.001) and they took better care of their own health (p < 0.001), compared to the BI group. The results indicate that the MI may represent an important supplement in the treatment of musculoskeletal pain.

Isometric muscle fatigue of the paravertebral and upper extremity muscles after whiplash injury.

PubMed

Rastovic, Pejana; Gojanovic, Marija Definis; Berberovic, Marina; Pavlovic, Marko; Lesko, Josip; Galic, Gordan; Pandza, Maja

2017-01-01

Whiplash-associated disorders (WAD) result from injury of neck structures that most often occur during traffic accidents as a result of rapid acceleration-deceleration. The dominant symptoms manifest in the musculoskeletal system and include increased fatigue. Because of the frequency of whiplash injuries, a simple, cheap and useful diagnostic tool is needed to differentiate whiplash injury from healthy patients or those faking symptoms. To determine muscle fatigue in patients with whiplash injury in six body positions. Analytical cross-sectional study. Emergency center, university hospital. We studied patients with whiplash injury from vehicular traffic accidents who presented to the emergency center within 6 hours of sustaining the injury. We determined whiplash injury grade according to the Quebec Task Force (QTF) classification and measured isometric muscle endurance in six different body positions. Control subjects for each patient were matched by age, gender and anthropomorphic characteristics. Cut-off values were determined to distinguish patients with whiplash injury from controls and for determination of injury grade . QTF grade, time to muscle fatigue in seconds. From September 2013 to September 2016, we enrolled 75 patients with whiplash injury and 75 matching control subjects. In all six positions, the patients with whiplash injury felt muscle fatigue faster than equivalent controls (P < .05) and the time to onset of muscle fatigue decreased with increasing injury grades in all six positions. Assignment to the patient or control group and to injury grade could be predicted with more than 90% accuracy on the basis of time to muscle fatigue. The most efficient position was the highest injury grade, by which 99.9% of the patients were accurately categorized. Isometric muscle endurance correlated with whiplash injury grade in all six positions (P < .01). Under clinical conditions, muscle endurance and the appearance of isometric muscle fatigue during testing can be a useful indicator of whiplash injury and grade. The size of the sample was small. An objective parameter such as electromyography is needed to confirm isometric muscle fatigue.

U.S. Army Deployment Injury Surveillance Summary Calendar Year 2008. 1 January 2008 - 31 December 2008

DTIC Science & Technology

2009-09-15

region affected. In 2008, 831 NBI-related musculoskeletal conditions required medical air evacuation. Inflammation and Pain (Overuse) Joint...evacuation were inflammation and pain (overuse) (56 percent), joint derangement (16 percent), and strains/sprains/rupture (13 percent). The spine/back...extremities (14 percent). The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) involving the lumbar

Sequences of upper and lower extremity motions in javelin throwing.

PubMed

Liu, Hui; Leigh, Steve; Yu, Bing

2010-11-01

Javelin throwing is technically demanding. Sequences of upper and lower extremity motions are important for javelin throwing performance. The purpose of this study was to determine the general sequences of upper and lower extremity motions of elite male and female javelin throwers. Three-dimensional kinematic data were collected for 32 female and 30 male elite javelin throwers during competitions. Shoulder, elbow, wrist, hip, knee, ankle, lower trunk, and upper trunk joint and segment angles were reduced for the best trial of each participant. Beginning times of 6 upper extremity and 10 lower extremity joint and segment angular motions were identified. Sequences of the upper and lower extremity motions were determined through statistical analyses. Upper and lower extremity motions of the male and female elite javelin throwers followed specific sequences (P ≤ 0.050). Upper extremity motions of the male and female elite javelin throwers did not follow a proximal-to-distal sequence as suggested in the literature. Male and female elite javelin throwers apparently employed different sequences for upper and lower extremity motions (P < 0.001). Further studies are needed to determine the effects of sequences of upper and lower extremity motions on javelin throwing performance.

Symptoms of musculoskeletal disorders among ammunition factory workers in Turkey.

PubMed

Pinar, Tevfik; Cakmak, Z Aytul; Saygun, Meral; Akdur, Recep; Ulu, Nuriye; Keles, Isik; Saylam, Hamdi Saim

2013-01-01

The aim of this study was to assess the prevalence of symptoms of work-related musculoskeletal disorders (MSDs) and to determine the risk factors among ammunition factory workers in Turkey. This cross-sectional study was performed on 955 ammunition factory workers. Potential risk factors were investigated with a questionnaire and multivariate logistic regression analysis was performed. During the previous year, 39.3% of ammunition workers experienced symptoms of work-related MSDs. Logistic regression analysis showed smoking (odds ratio [OR] = 1.372), chronic diseases (OR = 1.795), body mass index (BMI; overweight) (OR = 1.631), working year (OR = 1.509), cold temperature (OR = 1.838), and work load (OR = 2.210) were significant independent risk factors for the development of symptoms of MSDs. It was found that both work-related conditions and personal and environmental factors are important for the development of occupational MSDs.

[Segmental schwannomatosis in upper-extremity: 5 cases report and literature review].

PubMed

Wang, Zhi-Xin; Chen, Shan-Lin; Yi, Chuan-Jun; Li, Chun; Rong, Yan-Bo; Tian, Guang-Lei

2013-10-18

Multiple schwannomas localized in a single body part not crossing the midline constitute a rare variant of neurofibromatosis, segmental schwannomatosis. We report our experience with 5 cases of segmental schwannomatosis of the upper extremity and review the related literature to improve our skills in diagnosis and differentiation. Five patients with segmental schwannomatosis received surgical treatment in our department from 2003 to 2012, of whom 4 were female and the other one male. The mean age was 38 years, ranging from 29 to 48 years. In retrospect, we discussed the clinical appearance, histologic characteristics, genetic data and surgical management. A total of 351 patients with schwannomas were treated in the recent decade. There were 326 patients with solitary schwannoma, accounting for 92.88%, 25 with neurofibromatosis type 2 (NF-2), occupying 7.12% and 5 with segmental schwannomatosis representing 1.42% of the total. Schwannomas are limited in one upper extremity and randomly located at ulnar nerve, median nerve and radial nerve and their branches, with no obvious predisposition. Their family history was negative for cutaneous tumors or central nervous system disease. Neurological examinations did not reveal symptoms related to vestibular nerves or optic nerves, which excluded NF-2 preliminarily. The prior symptom of three cases was pain which could be irradiated to the nerve distribution area. No pain but slight numbness was found in two cases. MRI disclosed multiple masses along the course of the nerves. They were isointense to muscle on T1-weighed images and hyperintense to subcutaneous fat on T2-weighed images. All schwannomas were resected and histological sections exhibited a characteristic feature of schwannoma. Follow-up work of 4.5 years was done to 4 cases and no recurrence or impairment of nerves was found. Segmental schwannomatosis is characterized by multiple schwannomas localized in one limb (upper extremity in our cases) without vestibular nerve tumors, most frequently seen in females at the age of 30-60 years. Segmental schwannomatosis is rarely seen in the previous literature. We found around 20 cases in English articles and no cases in domestic articles. In consideration of the clinical appearances of these 5 cases and the genetic research in the related literature, we recommend that segmental schwannomatosis is a distinct form of neurofibromatosis which needs to be more studied. We should also pay more attention to differentiating this disease from other forms of neurofibromatosis.

Full-Body Musculoskeletal Model for Muscle-Driven Simulation of Human Gait.

PubMed

Rajagopal, Apoorva; Dembia, Christopher L; DeMers, Matthew S; Delp, Denny D; Hicks, Jennifer L; Delp, Scott L

2016-10-01

Musculoskeletal models provide a non-invasive means to study human movement and predict the effects of interventions on gait. Our goal was to create an open-source 3-D musculoskeletal model with high-fidelity representations of the lower limb musculature of healthy young individuals that can be used to generate accurate simulations of gait. Our model includes bony geometry for the full body, 37 degrees of freedom to define joint kinematics, Hill-type models of 80 muscle-tendon units actuating the lower limbs, and 17 ideal torque actuators driving the upper body. The model's musculotendon parameters are derived from previous anatomical measurements of 21 cadaver specimens and magnetic resonance images of 24 young healthy subjects. We tested the model by evaluating its computational time and accuracy of simulations of healthy walking and running. Generating muscle-driven simulations of normal walking and running took approximately 10 minutes on a typical desktop computer. The differences between our muscle-generated and inverse dynamics joint moments were within 3% (RMSE) of the peak inverse dynamics joint moments in both walking and running, and our simulated muscle activity showed qualitative agreement with salient features from experimental electromyography data. These results suggest that our model is suitable for generating muscle-driven simulations of healthy gait. We encourage other researchers to further validate and apply the model to study other motions of the lower extremity. The model is implemented in the open-source software platform OpenSim. The model and data used to create and test the simulations are freely available at https://simtk.org/home/full_body/, allowing others to reproduce these results and create their own simulations.

Full body musculoskeletal model for muscle-driven simulation of human gait

PubMed Central

Rajagopal, Apoorva; Dembia, Christopher L.; DeMers, Matthew S.; Delp, Denny D.; Hicks, Jennifer L.; Delp, Scott L.

2017-01-01

Objective Musculoskeletal models provide a non-invasive means to study human movement and predict the effects of interventions on gait. Our goal was to create an open-source, three-dimensional musculoskeletal model with high-fidelity representations of the lower limb musculature of healthy young individuals that can be used to generate accurate simulations of gait. Methods Our model includes bony geometry for the full body, 37 degrees of freedom to define joint kinematics, Hill-type models of 80 muscle-tendon units actuating the lower limbs, and 17 ideal torque actuators driving the upper body. The model’s musculotendon parameters are derived from previous anatomical measurements of 21 cadaver specimens and magnetic resonance images of 24 young healthy subjects. We tested the model by evaluating its computational time and accuracy of simulations of healthy walking and running. Results Generating muscle-driven simulations of normal walking and running took approximately 10 minutes on a typical desktop computer. The differences between our muscle-generated and inverse dynamics joint moments were within 3% (RMSE) of the peak inverse dynamics joint moments in both walking and running, and our simulated muscle activity showed qualitative agreement with salient features from experimental electromyography data. Conclusion These results suggest that our model is suitable for generating muscle-driven simulations of healthy gait. We encourage other researchers to further validate and apply the model to study other motions of the lower-extremity. Significance The model is implemented in the open source software platform OpenSim. The model and data used to create and test the simulations are freely available at https://simtk.org/home/full_body/, allowing others to reproduce these results and create their own simulations. PMID:27392337

Computer work and self-reported variables on anthropometrics, computer usage, work ability, productivity, pain, and physical activity.

PubMed

Madeleine, Pascal; Vangsgaard, Steffen; Hviid Andersen, Johan; Ge, Hong-You; Arendt-Nielsen, Lars

2013-08-01

Computer users often report musculoskeletal complaints and pain in the upper extremities and the neck-shoulder region. However, recent epidemiological studies do not report a relationship between the extent of computer use and work-related musculoskeletal disorders (WMSD).The aim of this study was to conduct an explorative analysis on short and long-term pain complaints and work-related variables in a cohort of Danish computer users. A structured web-based questionnaire including questions related to musculoskeletal pain, anthropometrics, work-related variables, work ability, productivity, health-related parameters, lifestyle variables as well as physical activity during leisure time was designed. Six hundred and ninety office workers completed the questionnaire responding to an announcement posted in a union magazine. The questionnaire outcomes, i.e., pain intensity, duration and locations as well as anthropometrics, work-related variables, work ability, productivity, and level of physical activity, were stratified by gender and correlations were obtained. Women reported higher pain intensity, longer pain duration as well as more locations with pain than men (P < 0.05). In parallel, women scored poorer work ability and ability to fulfil the requirements on productivity than men (P < 0.05). Strong positive correlations were found between pain intensity and pain duration for the forearm, elbow, neck and shoulder (P < 0.001). Moderate negative correlations were seen between pain intensity and work ability/productivity (P < 0.001). The present results provide new key information on pain characteristics in office workers. The differences in pain characteristics, i.e., higher intensity, longer duration and more pain locations as well as poorer work ability reported by women workers relate to their higher risk of contracting WMSD. Overall, this investigation confirmed the complex interplay between anthropometrics, work ability, productivity, and pain perception among computer users.

Duplex sonography for detection of deep vein thrombosis of upper extremities: a 13-year experience.

PubMed

Chung, Amy S Y; Luk, W H; Lo, Adrian X N; Lo, C F

2015-04-01

To determine the prevalence and characteristics of sonographically evident upper-extremity deep vein thrombosis in symptomatic Chinese patients and identify its associated risk factors. Regional hospital, Hong Kong. Data on patients undergoing upper-extremity venous sonography examinations during a 13-year period from November 1999 to October 2012 were retrieved. Variables including age, sex, history of smoking, history of lower-extremity deep vein thrombosis, major surgery within 30 days, immobilisation within 30 days, cancer (history of malignancy), associated central venous or indwelling catheter, hypertension, diabetes mellitus, sepsis within 30 days, and stroke within 30 days were tested using binary logistic regression to understand the risk factors for upper-extremity deep vein thrombosis. The presence of upper-extremity deep vein thrombosis identified. Overall, 213 patients with upper-extremity sonography were identified. Of these patients, 29 (13.6%) had upper-extremity deep vein thrombosis. The proportion of upper-extremity deep vein thrombosis using initial ultrasound was 0.26% of all deep vein thrombosis ultrasound requests. Upper limb swelling was the most common presentation seen in a total of 206 (96.7%) patients. Smoking (37.9%), history of cancer (65.5%), and hypertension (27.6%) were the more prevalent conditions among patients in the upper-extremity deep vein thrombosis-positive group. No statistically significant predictor of upper-extremity deep vein thrombosis was noted if all variables were included. After backward stepwise logistic regression, the final model was left with only age (P=0.119), female gender (P=0.114), and history of malignancy (P=0.024) as independent variables. History of malignancy remained predictive of upper-extremity deep vein thrombosis. Upper-extremity deep vein thrombosis is uncommon among symptomatic Chinese population. The most common sign is swelling and the major risk factor for upper-extremity deep vein thrombosis identified in this study is malignancy.

Longitudinal course of physical and psychological symptoms after a natural disaster

PubMed Central

Wahlström, Lars; Michélsen, Hans; Schulman, Abbe; Backheden, Hans; Keskinen-Rosenqvist, Riitta

2013-01-01

Background After disaster, physical symptoms are common although seldom recognized due to lack of knowledge of the course of symptoms and relation to more studied psychological symptoms. Objective This study aimed to investigate the change in the reporting of different physical symptoms after a disaster, including possible factors for change, and whether psychological symptoms predict physical symptoms reporting at a later point in time. Method A longitudinal study of citizens of Stockholm who survived the 2004 Indian Ocean tsunami. A total of 1,101 participants completed questionnaires on somatic symptoms, general distress, posttraumatic stress, exposure, and demographic details 14 months and 3 years after the disaster. Physical symptoms occurring daily or weekly during the last year were investigated in four symptom indices: neurological, cardiorespiratory, gastrointestinal, and musculoskeletal. We used generalized estimating equations (GEE) analysis to determine odds ratios for a change in symptoms, and pathway analysis to predict the influence of psychological symptoms on physical symptoms. Results There was a general decrease of reporting in all physical symptom indices except the musculoskeletal symptom index. The change in the neurological symptom index showed the strongest association with exposure, and for women. General distress and posttraumatic stress at 14 months postdisaster predicted physical symptoms at 3 years. Conclusion Physical symptoms were predicted by psychological symptoms at an earlier time point, but in a considerable proportion of respondents, physical symptoms existed independently from psychological symptoms. Physicians should be observant on the possible connection of particular pseudoneurological symptoms with prior adversities. PMID:24379941

Vitamin D status modifies the association between statin use and musculoskeletal pain: a population based study.

PubMed

Morioka, Travis Y; Lee, Alice J; Bertisch, Suzanne; Buettner, Catherine

2015-01-01

Past studies examining the effect of vitamin D on statin myalgia have been variable; however, these studies were done in limited samples not representative of the general population. We aimed to evaluate whether vitamin D status modifies the association between statin use and musculoskeletal pain in a sample representative of the general population. We conducted a cross-sectional study using the National Health and Nutrition Examination Survey 2001-2004. Musculoskeletal symptoms and statin use were self-reported. Vitamin D status was assessed using serum 25 hydroxyvitamin D (25[OH]D), categorized as <15 ng/mL or ≥15 ng/mL. To evaluate if vitamin D status modifies the association between statin use and prevalent musculoskeletal pain, we performed multivariable-adjusted logistic regression models stratified by 25(OH)D status. Among 5907 participants ≥40 years old, mean serum 25(OH)D was 23.6 ng/mL (95% CI, 22.9-24.3). In stratified multivariable-adjusted logistic regression models, individuals with 25(OH)D <15 ng/mL, using a statin had a significantly higher odds of musculoskeletal pain compared to those not using a statin (adjusted odds ratio [aOR], 1.90; 95% CI, 1.18-3.05). Among those with 25(OH)D ≥15 ng/mL, we found no significant association between statin use and musculoskeletal pain (aOR, 0.91; 95% CI, 0.71-1.16). Among adults ≥ 40 years old with 25(OH)D <15 ng/mL, statin users had nearly 2 times greater odds of reporting musculoskeletal pain compared to non-statin users. Our findings support the hypothesis that vitamin D deficiency modifies the risk of musculoskeletal symptoms experienced with statin use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Deformity or dysfunction? Osteopathic manipulation of the idiopathic cavus foot: A clinical suggestion.

PubMed Central

Gidali, Adi; Harris, Valerie

2010-01-01

Observed gait abnormalities are often related to a variety of foot deformities such as the cavus foot, also known as pes cavus, cavovarus, uncompensated varus, and the high arched foot. When gait abnormalities related to cavus foot deformities produce symptoms or contribute to dysfunctional movement of the lower extremity, foot orthotics are commonly used to accommodate the deformity and optimize the function of the lower extremity. In more severe cases, surgical intervention is common. Hypomobility of the many joints of the foot and ankle may be mistaken as an idiopathic cavus foot deformity. As for any other limb segment suspected of musculoskeletal dysfunction, it is suggested that joint mobility testing and mobilization, if indicated, be attempted on the foot and ankle joints before assuming the presence of a bony cavus deformity. The purpose of this clinical suggestion is to describe the use of osteopathic manipulations of the foot and ankle in the context of an illustrative case of bilateral idiopathic cavus feet to demonstrate that apparent foot deformities may actually be joint hypomobility dysfunctions. PMID:21509155

The proactive approach--is it worthwhile? A prospective controlled ergonomic intervention study in office workers.

PubMed

Laestadius, Jasminka Goldoni; Ye, Jian; Cai, Xiaodong; Ross, Sandra; Dimberg, Lennart; Klekner, Meg

2009-10-01

Does proactive ergonomics program enhance office worker health and productivity? The investigation was conducted in connection with the move of 1500 office staff to a building with improved ergonomics. It was focused on associations between workstation features, working postures, musculoskeletal pain symptoms, and eye strain before and 18 months after implementation of a proactive ergonomic program. The outcomes were compared between the intervention and a similar reference group. Associations between improvement of postures and less musculoskeletal pain and eye strain were confirmed. A cross association between several features and postures and improved symptoms was noted, along with improved productivity. The study suggests that a proactive program adhering to the OSHA recommendations needs to include an individual workstation assessment to be effective in reducing symptoms and increasing productivity.

Loads Carried by Soldiers: Historical, Physiological, Biomechanical and Medical Aspects

DTIC Science & Technology

1989-06-01

EMG and cinematographic data in the study of load carriage. They showed that EMG activity of the trapezius, rectus femorls, gastrocnemus and erector... abdominal muscles. Backpack loads of 18 to 27 kg did not change the magnitude of this pressure while walking (45). MEDICAL ASPECTS RUCKSACK PARALYSIS...symptoms included minor pain , paresthesias, numbness and paralysis of the upper extremities. The shoulder girdle and elbow flexor muscle groups were usually

Immediate and lasting effects of a thoracic spine manipulation in a patient with signs of cervical radiculopathy and upper extremity hyperalgesia: A case report.

PubMed

Deschenes, Beth K; Zafereo, Jason

2017-01-01

Patients with cervical radiculopathy (CR) may present with accompanying symptoms of hyperalgesia, allodynia, heaviness in the arm, and non-segmental pain that do not appear to be related to a peripheral spinal nerve. These findings may suggest the presence of central or autonomic nervous system involvement, requiring a modified management approach. The purpose of this case report is to describe the treatment of a patient with signs of CR and upper extremity (UE) hyperalgesia who had a significant decrease in her UE pain and hypersensitivity after a single thoracic spine manipulation (TSM). A 48-year-old female presented to physical therapy with acute neck pain radiating into her left UE that significantly limited her ability to sleep and work. After a single TSM, the patient demonstrated immediate and lasting reduction in hyperalgesia, hypersensitivity to touch, elimination of perceived heaviness and coldness in her left UE, and improved strength in the C6-8 myotome, allowing for improved functional activity capacity and tolerance to a multi-modal PT program. Based on these results, clinicians should consider the early application of TSM in patients with CR who have atypical, widespread, or severe neurological symptoms that limit early mobilization and tolerance to treatment at the painful region.